Healthcare Provider Details

I. General information

NPI: 1922449677
Provider Name (Legal Business Name): YAHIRA MONTANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 W 239TH ST
BRONX NY
10463-1205
US

IV. Provider business mailing address

780 PELHAM PKWY S APT C8
BRONX NY
10462-1104
US

V. Phone/Fax

Practice location:
  • Phone: 718-601-2280
  • Fax:
Mailing address:
  • Phone: 646-710-0678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number088978
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: