Provider Demographics
NPI:1588894547
Name:MONTAG, MEGAN CLAIRE (RD, LDN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:CLAIRE
Last Name:MONTAG
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 OSBORNE ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4146
Mailing Address - Country:US
Mailing Address - Phone:814-539-0798
Mailing Address - Fax:814-536-4751
Practice Address - Street 1:88 OSBORNE ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4146
Practice Address - Country:US
Practice Address - Phone:814-539-0798
Practice Address - Fax:814-536-4751
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003538133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered