Provider Demographics
NPI:1114498086
Name:MONTERO, ZULEYKA
Entity Type:Individual
Prefix:
First Name:ZULEYKA
Middle Name:
Last Name:MONTERO
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 1:85 INDUSTRIAL CIR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-2645
Mailing Address - Country:US
Mailing Address - Phone:401-617-3971
Mailing Address - Fax:401-633-6421
Practice Address - Street 1:85 INDUSTRIAL CIR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-2645
Practice Address - Country:US
Practice Address - Phone:401-617-3971
Practice Address - Fax:401-633-6421
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver