Provider Demographics
NPI:1073060778
Name:MONTEIRO, IDALINA
Entity Type:Individual
Prefix:MISS
First Name:IDALINA
Middle Name:
Last Name:MONTEIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 LAUDER AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6218
Mailing Address - Country:US
Mailing Address - Phone:508-510-2940
Mailing Address - Fax:
Practice Address - Street 1:203 CROSS ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2116
Practice Address - Country:US
Practice Address - Phone:508-510-2940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health