MEDICARE: TIANA MONTELLA RD

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
1	133V00000X	Registered Dietitian	7870	OH

General Provider Information

NPI Number	:	1255094306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIANA MONTELLA RD

Provider Business Mailing Address
First Line	:	5 E LONG ST FL 11
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-2915
Country	:	US
Telephone Number	:	614-282-7714
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 E LONG ST FL 11
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-2915
Country	:	US
Telephone Number	:	614-282-7714
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2021
Last Update Date	:	12/19/2025

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