Provider Demographics
NPI:1568065704
Name:MONTEBELLO, NICHOLAS (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:
Last Name:MONTEBELLO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CYPRESS CIR
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1653
Mailing Address - Country:US
Mailing Address - Phone:267-549-7828
Mailing Address - Fax:
Practice Address - Street 1:45 CHELTENHAM AVE
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012-1412
Practice Address - Country:US
Practice Address - Phone:267-549-7828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4437151835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist