Provider Demographics
NPI:1013002831
Name:MONTGOMERY, CATHERINE P (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:P
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E EVESHAM RD
Mailing Address - Street 2:SUITE 503
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4501
Mailing Address - Country:US
Mailing Address - Phone:856-772-1711
Mailing Address - Fax:856-772-1758
Practice Address - Street 1:2301 E EVESHAM RD
Practice Address - Street 2:SUITE 503
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4501
Practice Address - Country:US
Practice Address - Phone:856-772-1711
Practice Address - Fax:856-772-1758
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA05658700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ00673Medicare ID - Type Unspecified
NJF58944Medicare UPIN