Provider Demographics
NPI:1811342744
Name:MONTORO, MARYANNE
Entity type:Individual
Prefix:MRS
First Name:MARYANNE
Middle Name:
Last Name:MONTORO
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 1:6716 TOWNE CENTER BLVD
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-6933
Mailing Address - Country:US
Mailing Address - Phone:814-644-6922
Mailing Address - Fax:
Practice Address - Street 1:6716 TOWNE CENTER BLVD
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-6933
Practice Address - Country:US
Practice Address - Phone:814-644-6922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040718L183500000X
PARPI009130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist