Provider Demographics
NPI:1265461537
Name:MONTIEL, NORMA JEANETTE (DO)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:JEANETTE
Last Name:MONTIEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:NORMA
Other - Middle Name:JEANETTE
Other - Last Name:MONTIEL-GELVES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:3 DELAWARE DR
Mailing Address - Street 2:4 PROHEATH PLAZA
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1116
Mailing Address - Country:US
Mailing Address - Phone:516-608-2830
Mailing Address - Fax:516-622-6199
Practice Address - Street 1:3 DELAWARE DR
Practice Address - Street 2:4 PROHEATH PLAZA
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1116
Practice Address - Country:US
Practice Address - Phone:516-608-2830
Practice Address - Fax:516-622-6199
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219386-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology