Provider Demographics
NPI:1003097502
Name:MONTERROYO, CARLOS NEILFREID (PT)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:NEILFREID
Last Name:MONTERROYO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 CHAPEL AVE W
Mailing Address - Street 2:APARTMENT 4U
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-3801
Mailing Address - Country:US
Mailing Address - Phone:856-313-1677
Mailing Address - Fax:
Practice Address - Street 1:120 E CAMDEN AVE
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-1625
Practice Address - Country:US
Practice Address - Phone:856-778-8996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01100200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist