Provider Demographics
NPI:1235751769
Name:MONTESCLAROS, MONICA (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MONTESCLAROS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-2706
Mailing Address - Country:US
Mailing Address - Phone:718-578-1880
Mailing Address - Fax:
Practice Address - Street 1:9 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-2706
Practice Address - Country:US
Practice Address - Phone:718-578-1880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJF05200087363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily