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General NPI Number Information
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NPI Number | 1225788698
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Entity Type | Individual
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Provider Name | BIANCA MONTALVO
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Gender | Female
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 550 S GODDARD BLVD
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-2922
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Country | US
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Telephone | 610-337-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 100 LENNOX CT
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City | LANSDALE
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State | PA
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Zip | 19446-6378
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Country | US
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Telephone | 203-217-3507
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP025732
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | RN710420
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License Number State | PA
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