Provider Demographics
NPI:1164849568
Name:MONTALBANO-STARITA, ENRICA-ANNE M (LMT)
Entity Type:Individual
Prefix:
First Name:ENRICA-ANNE
Middle Name:M
Last Name:MONTALBANO-STARITA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 METAIRIE RD
Mailing Address - Street 2:SUITE 22
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3938
Mailing Address - Country:US
Mailing Address - Phone:504-252-0026
Mailing Address - Fax:
Practice Address - Street 1:4322 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5945
Practice Address - Country:US
Practice Address - Phone:504-252-0026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA 7657225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist