Provider Demographics
NPI:1922449677
Name:MONTANO, YAHIRA
Entity Type:Individual
Prefix:
First Name:YAHIRA
Middle Name:
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 1:780 PELHAM PKWY S APT C8
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1104
Mailing Address - Country:US
Mailing Address - Phone:646-710-0678
Mailing Address - Fax:
Practice Address - Street 1:521 W 239TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1205
Practice Address - Country:US
Practice Address - Phone:718-601-2280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088978104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker