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General NPI Number Information
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NPI Number | 1952178774
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Entity Type | Individual
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Provider Name | MARSHA MONTFORT
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Gender | Female
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 184 ELDRIDGE ST
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City | NEW YORK
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State | NY
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Zip | 10002-2992
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Country | US
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Telephone | 212-453-4522
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Fax |
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Provider Business Mailing Address
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Address Line | 565 LIVONIA AVE
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City | BROOKLYN
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State | NY
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Zip | 11207-5209
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Country | US
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Telephone |
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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