Healthcare Provider Details

I. General information

NPI: 1245524628
Provider Name (Legal Business Name): ALANNA MONTALVAN PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ALANNA RODRIGUEZ

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E 23RD ST STE 300
NEW YORK NY
10010-4588
US

IV. Provider business mailing address

13 BRYCE AVE
GLEN COVE NY
11542-2013
US

V. Phone/Fax

Practice location:
  • Phone: 646-650-5032
  • Fax: 888-683-3660
Mailing address:
  • Phone: 929-409-0928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF401963-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number641262
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: