Provider Demographics
NPI:1780676312
Name:MONTONI, VINCENZO (DO)
Entity Type:Individual
Prefix:DR
First Name:VINCENZO
Middle Name:
Last Name:MONTONI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:233 7TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5747
Mailing Address - Country:US
Mailing Address - Phone:516-742-5344
Mailing Address - Fax:516-742-3740
Practice Address - Street 1:233 7TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5747
Practice Address - Country:US
Practice Address - Phone:516-742-5344
Practice Address - Fax:516-742-3740
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200905207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G67519Medicare UPIN
NYA400143139Medicare PIN