Provider Demographics
NPI:1689253270
Name:MONTANARO, AIMEE (L AC)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:MONTANARO
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SAINT JOHNS PL
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-2500
Mailing Address - Country:US
Mailing Address - Phone:203-257-0776
Mailing Address - Fax:
Practice Address - Street 1:64 HUNTINGTON ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-5212
Practice Address - Country:US
Practice Address - Phone:203-257-0776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000779171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist