MEDICARE: DELIA MONTALTO MD

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	207W00000X	Ophthalmology Physician	304518	NY

General Provider Information

NPI Number	:	1508220591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELIA MONTALTO MD

Provider Business Mailing Address
First Line	:	125 KENNEDY DR STE 400
Second Line	:
City	:	HAUPPAUGE
State	:	NY
Zip	:	11788-4017
Country	:	US
Telephone Number	:	855-295-4144
Fax Number	:	631-257-5098

Provider Business Practice Location Address
First Line	:	153 MAIN ST
Second Line	:
City	:	SAYVILLE
State	:	NY
Zip	:	11782-2503
Country	:	US
Telephone Number	:	855-295-4144
Fax Number	:	631-257-5098

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

Provider Enumeration Date	:	04/06/2016
Last Update Date	:	03/23/2021

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Directions to “ DELIA MONTALTO MD” Practice Location

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