Healthcare Provider Details

I. General information

NPI: 1750211678
Provider Name (Legal Business Name): PETER D MONTAN NURSE PRACTITIONER IN FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 GRAND CONCOURSE
BRONX NY
10468-1442
US

IV. Provider business mailing address

3131 GRAND CONCOURSE
BRONX NY
10468-1442
US

V. Phone/Fax

Practice location:
  • Phone: 917-728-9528
  • Fax:
Mailing address:
  • Phone: 917-728-9528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER D MONTAN
Title or Position: OWNER
Credential: FNP-BC, APRN
Phone: 917-728-9528