Provider Demographics
NPI:1265486898
Name:MONTANO, DANIE TEJADO (PA)
Entity Type:Individual
Prefix:
First Name:DANIE
Middle Name:TEJADO
Last Name:MONTANO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USA MEDDAC WUERZBURG
Mailing Address - Street 2:ATTN: CREDENTIALS OFFICE, UNIT 26610
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09224
Mailing Address - Country:US
Mailing Address - Phone:0114-993-1804
Mailing Address - Fax:3241
Practice Address - Street 1:USA MEDDAC WUERZBURG
Practice Address - Street 2:CONN CTMC
Practice Address - City:APO AE
Practice Address - State:NY
Practice Address - Zip Code:09226-0000
Practice Address - Country:US
Practice Address - Phone:011-499-7219
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCPA 1051879363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical