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General NPI Number Information
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NPI Number | 1316667405
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Entity Type | Individual
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Provider Name | MARIE DENISE MONTGOMERY PH.D
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Gender | Female
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 09/05/2022
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Provider Practice Location Address
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Address Line | 8412 CEDARBROOK AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19150-1002
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Country | US
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Telephone | 215-668-8984
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Fax | 267-335-4078
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Provider Business Mailing Address
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Address Line | 8412 CEDARBROOK AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19150-1002
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Country | US
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Telephone | 215-668-8984
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Fax | 267-335-4078
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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 | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | YM006122L
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License Number State | PA
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