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General NPI Number Information
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NPI Number | 1417194671
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Entity Type | Organization
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Legal Business Name | NIRMALA L MONTEIRO MD LLC
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Dates
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Enumeration Date | 01/09/2009
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Last Update Date | 01/09/2009
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Provider Practice Location Address
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Address Line | 52 BEACH RD SUITE 107
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City | FAIRFIELD
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State | CT
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Zip | 06824-6017
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Country | US
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Telephone | 203-292-6500
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Fax | 203-292-6502
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Provider Business Mailing Address
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Address Line | 52 BEACH RD SUITE 107
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City | FAIRFIELD
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State | CT
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Zip | 06824-6017
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Country | US
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Telephone | 203-292-6500
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Fax | 203-292-6502
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Authorized Official
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Title or Position | OWNER
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Name | DR. NIRMALA LOIS MONTEIRO
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Credential | MD
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Telephone | 203-292-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 026844
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License Number State | CT
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