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NPI Code Detail

MEDICARE: JOSEPH W. MONTAGNINO, MDPA

MEDICARE: JOSEPH W. MONTAGNINO, MDPA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2500XMedical Specialty Clinic/Center25MA03358100NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174835300
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSEPH W. MONTAGNINO, MDPA
Provider Business Mailing Address
First Line : PO BOX 98
Second Line :
City : WYCKOFF
State : NJ
Zip : 07481-0098
Country : US
Telephone Number : 973-238-0055
Fax Number : 973-238-9826
Provider Business Practice Location Address
First Line : 625 LAFAYETTE AVE
Second Line :
City : HAWTHORNE
State : NJ
Zip : 07506-3401
Country : US
Telephone Number : 973-238-0055
Fax Number : 973-238-9826
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. LILIA B MONTAGNINO
Credential : R.N.
Telephone Number : 973-238-0055
Provider Enumeration Date : 07/02/2010
Last Update Date : 07/02/2010

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