Provider Demographics
NPI:1043553266
Name:MONTI, ALISON C (RD,CSG,CDN)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:C
Last Name:MONTI
Suffix:
Gender:F
Credentials:RD,CSG,CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8837 SABRE ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2725
Mailing Address - Country:US
Mailing Address - Phone:516-317-0236
Mailing Address - Fax:
Practice Address - Street 1:11126 CORONA AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11368-4027
Practice Address - Country:US
Practice Address - Phone:516-317-0236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006907-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered