Provider Demographics
NPI:1861847626
Name:MONTANO, CAROLINA MARIA
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:MARIA
Last Name:MONTANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LONGWOOD AVE BOSTON CHILDREN'S HOSPITAL,
Mailing Address - Street 2:HUNNEWELL BUILDING, PAVILION 129, HOUSESTAFF LOUNGE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE BOSTON CHILDREN'S HOSPITAL,
Practice Address - Street 2:HUNNEWELL BUILDING, PAVILION 129, HOUSESTAFF LOUNGE,
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:443-682-2213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program