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General NPI Number Information
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NPI Number | 1194835629
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Entity Type | Individual
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Provider Name | RAYMOND C MONTANARO P.A.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 30 HAGEN DR STE 220
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City | ROCHESTER
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State | NY
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Zip | 14625-2658
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Country | US
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Telephone | 585-295-5302
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Fax | 585-248-0567
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Provider Business Mailing Address
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Address Line | 30 HAGEN DR STE 220
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City | ROCHESTER
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State | NY
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Zip | 14625-2658
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Country | US
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Telephone | 585-295-5302
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Fax | 585-248-0567
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 008722
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License Number State | NY
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