Provider Demographics
NPI:1629496880
Name:MONTI, RYAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:M
Last Name:MONTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 BAY AVENUE MONTCLAIR
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042
Mailing Address - Country:US
Mailing Address - Phone:973-429-6196
Mailing Address - Fax:973-429-6575
Practice Address - Street 1:1 BAY AVENUE MONTCLAIR
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042
Practice Address - Country:US
Practice Address - Phone:973-429-6196
Practice Address - Fax:973-429-6575
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA078999208M00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty