=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003756370
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALIEHTYS REYES MONTOYA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2026
-----------------------------------------------------
Last Update Date | 03/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 FORREST DR APT 2E
-----------------------------------------------------
City | RENSSELAER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12144-4533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-677-3693
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 FORREST DR APT 2E
-----------------------------------------------------
City | RENSSELAER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12144-4533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-677-3693
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WH0500X
-----------------------------------------------------
Taxonomy Name | Hemodialysis Registered Nurse
-----------------------------------------------------
License Number | 784376-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------