Healthcare Provider Details

I. General information

NPI: 1275527673
Provider Name (Legal Business Name): ANA MONTEAGUDO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

550 1ST AVE
NEW YORK NY
10016-6402
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-8610
  • Fax:
Mailing address:
  • Phone: 212-263-7021
  • Fax: 212-263-8690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number155677
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: