Provider Demographics
NPI:1346086881
Name:MONTES, GILBERTO
Entity type:Individual
Prefix:
First Name:GILBERTO
Middle Name:
Last Name:MONTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 POWELL AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08110-1126
Mailing Address - Country:US
Mailing Address - Phone:814-889-9520
Mailing Address - Fax:
Practice Address - Street 1:674 BEAR VALLEY AVE
Practice Address - Street 2:
Practice Address - City:SHAMOKIN
Practice Address - State:PA
Practice Address - Zip Code:17872-6317
Practice Address - Country:US
Practice Address - Phone:814-889-9520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility