Provider Demographics
NPI:1417568296
Name:MONTI, CRYSTAL ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ELIZABETH
Last Name:MONTI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8390 DELMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2107
Mailing Address - Country:US
Mailing Address - Phone:314-991-3402
Mailing Address - Fax:314-991-8473
Practice Address - Street 1:8390 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2107
Practice Address - Country:US
Practice Address - Phone:314-991-3402
Practice Address - Fax:314-991-8473
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016021941183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist