Most Relevant Information
Provider Data
| NPI Number: | 1003255928 |
| Provider Name: | IVETH VIVIANA MONTANA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/25/2013 |
| Last Updated: | 06/25/2013 |
Provider Practice Location
825 W END AVE
NEW YORK
NY
100255349
Practice Location Phone/Fax
| Phone: | 6463532405 |
| Fax: | 2126229222 |
Provider Mailing Location
825 W END AVE
NEW YORK
NY
100255349
Provider Mailing Phone/Fax
| Phone: | 6463532405 |
| Fax: | 2126229222 |