MEDICARE: KRISTEN MONTEIRO RN

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	363LF0000X	Family Nurse Practitioner	F357400	NY
2	163WS0200X	School Registered Nurse	654121	NY

General Provider Information

NPI Number	:	1477096956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN MONTEIRO RN

Provider Business Mailing Address
First Line	:	1344 MIDDLE COUNTRY RD STE 1
Second Line	:
City	:	CENTEREACH
State	:	NY
Zip	:	11720-3584
Country	:	US
Telephone Number	:	631-561-7484
Fax Number	:

Provider Business Practice Location Address
First Line	:	1344 MIDDLE COUNTRY RD
Second Line	:
City	:	CENTEREACH
State	:	NY
Zip	:	11720-3583
Country	:	US
Telephone Number	:	631-268-3010
Fax Number	:

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

Provider Enumeration Date	:	12/01/2016
Last Update Date	:	10/09/2025

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