Provider Demographics
NPI:1194863381
Name:MONTEAU, LUCIEN (RPA-C, MPH)
Entity Type:Individual
Prefix:MR
First Name:LUCIEN
Middle Name:
Last Name:MONTEAU
Suffix:
Gender:M
Credentials:RPA-C, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 W 168TH ST PH 137
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-939-2250
Mailing Address - Fax:212-939-4991
Practice Address - Street 1:154 N 7TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-2910
Practice Address - Country:US
Practice Address - Phone:718-414-2013
Practice Address - Fax:718-414-2015
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2019-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003880363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant