Provider Demographics
NPI:1588069827
Name:MONTINOLA, MA ISABEL INEZ (RN)
Entity type:Individual
Prefix:
First Name:MA ISABEL INEZ
Middle Name:
Last Name:MONTINOLA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 WEBER ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5826
Mailing Address - Country:US
Mailing Address - Phone:347-955-7559
Mailing Address - Fax:
Practice Address - Street 1:1139 WEBER ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5826
Practice Address - Country:US
Practice Address - Phone:347-955-7559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6127591163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse