Provider Demographics
NPI:1881034544
Name:MONTANO, SALOMON
Entity Type:Individual
Prefix:MR
First Name:SALOMON
Middle Name:
Last Name:MONTANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16112
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87191-1612
Mailing Address - Country:US
Mailing Address - Phone:505-798-9919
Mailing Address - Fax:505-798-9919
Practice Address - Street 1:9000 CAMINO DEL SOL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1418
Practice Address - Country:US
Practice Address - Phone:505-798-9919
Practice Address - Fax:505-798-9919
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health