Provider Demographics
NPI:1093925265
Name:MONTI, LISA C (RD, MS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:C
Last Name:MONTI
Suffix:
Gender:F
Credentials:RD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 DAVIES AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-2518
Mailing Address - Country:US
Mailing Address - Phone:201-244-9460
Mailing Address - Fax:
Practice Address - Street 1:260 GODWIN AVE
Practice Address - Street 2:REAR SUITE 2
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-5200
Practice Address - Country:US
Practice Address - Phone:551-404-4943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered