Provider Demographics
NPI:1699087312
Name:JANNETH MONTOYA M.D.,P.C.
Entity type:Organization
Organization Name:JANNETH MONTOYA M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JANNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTOYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-346-8999
Mailing Address - Street 1:35 E GRASSY SPRAIN RD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-4620
Mailing Address - Country:US
Mailing Address - Phone:914-346-8999
Mailing Address - Fax:914-346-8998
Practice Address - Street 1:35 E GRASSY SPRAIN RD
Practice Address - Street 2:SUITE 405
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-4620
Practice Address - Country:US
Practice Address - Phone:914-346-8999
Practice Address - Fax:914-346-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-10
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216114207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100030474Medicare PIN