Healthcare Provider Details

I. General information

NPI: 1548317068
Provider Name (Legal Business Name): PATRICIA MONTIGROS APN C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 BRUNSWICK AVENUE GREATER TRENTON BEHAVIORAL HEALTH CARE
TRENTON NJ
08607
US

IV. Provider business mailing address

78 TOWER HILL AVENUE
RED BANK NJ
07701-2260
US

V. Phone/Fax

Practice location:
  • Phone: 609-396-8877
  • Fax: 609-396-6024
Mailing address:
  • Phone: 732-842-3315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP26NJ00038000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: