Provider Demographics
NPI:1578905352
Name:MONTEROSSO, ANGELA S (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:S
Last Name:MONTEROSSO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 HUDSON ST STE 700
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5642
Mailing Address - Country:US
Mailing Address - Phone:201-449-1000
Mailing Address - Fax:201-399-2433
Practice Address - Street 1:79 HUDSON ST STE 700
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5642
Practice Address - Country:US
Practice Address - Phone:201-449-1000
Practice Address - Fax:201-399-2433
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00312300363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant