Provider Demographics
NPI:1578690608
Name:MONTALBANO, EILEEN (R,N,)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:
Last Name:MONTALBANO
Suffix:
Gender:F
Credentials:R,N,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 COTTONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PIERMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10968-1099
Mailing Address - Country:US
Mailing Address - Phone:845-365-2159
Mailing Address - Fax:
Practice Address - Street 1:308 COTTONWOOD CT
Practice Address - Street 2:
Practice Address - City:PIERMONT
Practice Address - State:NY
Practice Address - Zip Code:10968-1099
Practice Address - Country:US
Practice Address - Phone:845-365-2159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4866039163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse