Provider Demographics
NPI:1437246162
Name:MONTEMAYOR, NATALIE M (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:M
Last Name:MONTEMAYOR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5800 3RD AVE
Mailing Address - Street 2:MANAGED CARE DEPARTMENT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3702
Mailing Address - Country:US
Mailing Address - Phone:718-630-7477
Mailing Address - Fax:718-630-7437
Practice Address - Street 1:150 55TH ST
Practice Address - Street 2:SHORE ROAD RADIOLOGY ASSOCIATES PC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2559
Practice Address - Country:US
Practice Address - Phone:718-630-7400
Practice Address - Fax:718-630-7437
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1943392085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02355379Medicaid
NYH33731Medicare UPIN
NY02355379Medicaid