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General NPI Number Information
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NPI Number | 1326601709
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Entity Type | Individual
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Provider Name | BRUCE MONTELEON
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Gender | Male
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Dates
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Enumeration Date | 04/21/2019
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 173 MAINE AVENUE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-1031
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Country | US
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Telephone | 718-720-1528
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Fax |
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Provider Business Mailing Address
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Address Line | 49 MANOR DR
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City | MARLBORO
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State | NJ
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Zip | 07746-1972
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Country | US
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Telephone | 908-628-1995
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 44SC06059400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 055623
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License Number State | NY
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