Provider Demographics
NPI:1073796439
Name:MONTANTE, ANDREW M (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:M
Last Name:MONTANTE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 YOUNG ST
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-2208
Mailing Address - Country:US
Mailing Address - Phone:716-692-1894
Mailing Address - Fax:716-692-0616
Practice Address - Street 1:10 YOUNG ST
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-2208
Practice Address - Country:US
Practice Address - Phone:716-692-1894
Practice Address - Fax:716-692-0616
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist