Provider Demographics
NPI:1285858951
Name:MONTERO, DOLORES F (PT, DPT, GCS)
Entity Type:Individual
Prefix:
First Name:DOLORES
Middle Name:F
Last Name:MONTERO
Suffix:
Gender:F
Credentials:PT, DPT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-6653
Mailing Address - Country:US
Mailing Address - Phone:518-858-5529
Mailing Address - Fax:
Practice Address - Street 1:15 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-6653
Practice Address - Country:US
Practice Address - Phone:518-858-5529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012404-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist