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NPI Code Detail

MEDICARE: LAUREN THERESA MONTALVO

MEDICARE: LAUREN THERESA MONTALVO
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerSP033261PA
2363LF0000XFamily Nurse PractitionerSP029145PA

General Provider Information

NPI Number : 1366203648
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN THERESA MONTALVO
Provider Business Mailing Address
First Line : 2600 N AMERICAN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19133-3413
Country : US
Telephone Number : 201-560-6454
Fax Number :
Provider Business Practice Location Address
First Line : 2600 N AMERICAN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19133-3413
Country : US
Telephone Number : 201-560-6454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2024
Last Update Date : 03/29/2026

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Directions to “ LAUREN THERESA MONTALVO ” Practice Location

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