Provider Demographics
NPI:1184198822
Name:MONTE, TERRENCE (LAC)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:
Last Name:MONTE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:TERRENCE
Other - Middle Name:
Other - Last Name:MONTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:134 W 26TH ST RM 1200
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6863
Mailing Address - Country:US
Mailing Address - Phone:310-488-3876
Mailing Address - Fax:
Practice Address - Street 1:134 W 26TH ST RM 1200
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6863
Practice Address - Country:US
Practice Address - Phone:310-499-3876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006460171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist