Provider Demographics
NPI:1417194671
Name:NIRMALA L MONTEIRO MD LLC
Entity Type:Organization
Organization Name:NIRMALA L MONTEIRO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRMALA
Authorized Official - Middle Name:LOIS
Authorized Official - Last Name:MONTEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-292-6500
Mailing Address - Street 1:52 BEACH RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6017
Mailing Address - Country:US
Mailing Address - Phone:203-292-6500
Mailing Address - Fax:203-292-6502
Practice Address - Street 1:52 BEACH RD
Practice Address - Street 2:SUITE 107
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6017
Practice Address - Country:US
Practice Address - Phone:203-292-6500
Practice Address - Fax:203-292-6502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty