Provider Demographics
NPI:1164658985
Name:MONTES, MELBA LISSETTE (NP)
Entity Type:Individual
Prefix:MRS
First Name:MELBA
Middle Name:LISSETTE
Last Name:MONTES
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:550 1ST AVE # 15SOUTH5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-562-3917
Mailing Address - Fax:212-263-8640
Practice Address - Street 1:9413 FLATLANDS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236
Practice Address - Country:US
Practice Address - Phone:718-257-6615
Practice Address - Fax:718-272-3365
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2018-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY340716363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology