Provider Demographics
NPI:1568588788
Name:MONTENEGRO-ESPINA, PARALUMAN MEDROCILLO (NP)
Entity Type:Individual
Prefix:MRS
First Name:PARALUMAN
Middle Name:MEDROCILLO
Last Name:MONTENEGRO-ESPINA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107-18 92ND STREET
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417
Mailing Address - Country:US
Mailing Address - Phone:718-323-0352
Mailing Address - Fax:
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:2C-125
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304266363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health