Provider Demographics
NPI:1598832016
Name:MONTES, EDUARDO (MD)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:
Last Name:MONTES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1751
Mailing Address - Country:US
Mailing Address - Phone:201-236-3910
Mailing Address - Fax:
Practice Address - Street 1:8701 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5252
Practice Address - Country:US
Practice Address - Phone:201-861-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04947900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ18Y81OtherEMPIRE BLUE CROSS BLUE SH
223105991-001OtherSELF INSURED SERVICES
NJS53K1OtherEMPIRE BCBSNJ
NJ78022231059910OtherHORIZON BCBSNJ
2508202OtherAETNA
223105991-0003OtherCIGNA
USA899999OtherBLUE SHIELD OF CALIFORNIA
223105991-001OtherSELF INSURED SERVICES
223105991-0003OtherCIGNA