Provider Demographics
NPI:1174628267
Name:MONSERRATE,OTANO & PIJEM
Entity Type:Organization
Organization Name:MONSERRATE,OTANO & PIJEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIJEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-765-0054
Mailing Address - Street 1:539A CALLE S CUEVAS BUSTAMANTE
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2681
Mailing Address - Country:US
Mailing Address - Phone:787-765-0054
Mailing Address - Fax:787-812-0565
Practice Address - Street 1:539A CALLE S CUEVAS BUSTAMANTE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2681
Practice Address - Country:US
Practice Address - Phone:787-765-0054
Practice Address - Fax:787-812-0565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0026106Medicare ID - Type Unspecified