Provider Demographics
NPI:1649219478
Name:MONTIEL, ARMANDO ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMANDO
Middle Name:ANTONIO
Last Name:MONTIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 N WHITE HORSE PK
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106
Mailing Address - Country:US
Mailing Address - Phone:856-310-0477
Mailing Address - Fax:856-310-1835
Practice Address - Street 1:23 N WHITE HORSE PK
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106
Practice Address - Country:US
Practice Address - Phone:856-310-0477
Practice Address - Fax:856-310-1835
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2011-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA44320207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0097430002OtherAMERIHEALTH
NJ223244098OtherHORIZON
NJ0332208Medicaid
B80047Medicare UPIN
NJ441132Medicare ID - Type Unspecified