Healthcare Provider Details

I. General information

NPI: 1760814800
Provider Name (Legal Business Name): CHRISTINE ANN MONTIERDE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 BELLEMEADE AVE
SMITHTOWN NY
11787-1857
US

IV. Provider business mailing address

9017 181ST ST
HOLLIS NY
11423-2334
US

V. Phone/Fax

Practice location:
  • Phone: 718-749-2772
  • Fax:
Mailing address:
  • Phone: 718-749-2772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF382859-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: