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General NPI Number Information
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NPI Number | 1386334357
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Entity Type | Organization
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Legal Business Name | INGRID L. MONTGOMERY MD MPH PLLC
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 189 S PEARL ST
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City | PEARL RIVER
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State | NY
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Zip | 10965-2239
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Country | US
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Telephone | 845-502-6472
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Fax |
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Provider Business Mailing Address
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Address Line | 52 W PROSPECT ST
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City | NANUET
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State | NY
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Zip | 10954-2621
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Country | US
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Telephone | 845-502-6472
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. INGRID MONTGOMERY
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Credential | MD
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Telephone | 845-502-6472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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