Provider Demographics
NPI:1568105708
Name:MONTICELLO, BRITNEE LASHELLE (DO)
Entity Type:Individual
Prefix:
First Name:BRITNEE
Middle Name:LASHELLE
Last Name:MONTICELLO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MADISON AVE STE 2B
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3219
Mailing Address - Country:US
Mailing Address - Phone:607-732-1310
Mailing Address - Fax:
Practice Address - Street 1:200 MADISON AVE STE 2B
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3219
Practice Address - Country:US
Practice Address - Phone:607-732-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program