Provider Demographics
NPI:1528477973
Name:MONTANE, ELAINE
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:
Last Name:MONTANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 WOLF RUN
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-2842
Mailing Address - Country:US
Mailing Address - Phone:203-561-2728
Mailing Address - Fax:
Practice Address - Street 1:491 WOLF RUN
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-2842
Practice Address - Country:US
Practice Address - Phone:203-561-2728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist