Provider Demographics
NPI:1033323506
Name:MONTANA, CHISTOPHER J (DC)
Entity Type:Individual
Prefix:DR
First Name:CHISTOPHER
Middle Name:J
Last Name:MONTANA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 COWIE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-2841
Mailing Address - Country:US
Mailing Address - Phone:973-955-4191
Mailing Address - Fax:908-289-8588
Practice Address - Street 1:426 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3609
Practice Address - Country:US
Practice Address - Phone:908-289-5336
Practice Address - Fax:908-289-8588
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC05636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0047163Medicaid
NJV01811Medicare UPIN
NJ084371Medicare ID - Type Unspecified