Provider Demographics
NPI:1083847461
Name:MONTEMURRO, MARY (RNC,NP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:MONTEMURRO
Suffix:
Gender:F
Credentials:RNC,NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8667
Mailing Address - Country:US
Mailing Address - Phone:212-604-8256
Mailing Address - Fax:
Practice Address - Street 1:203 W 12TH ST
Practice Address - Street 2:616
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7762
Practice Address - Country:US
Practice Address - Phone:212-604-8256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310003-1163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult