Provider Demographics
NPI:1952832875
Name:MONTAPERTO, ANN
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:MONTAPERTO
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 1:2545 MILLERSPORT HWY
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1445
Mailing Address - Country:US
Mailing Address - Phone:716-688-9035
Mailing Address - Fax:
Practice Address - Street 1:2545 MILLERSPORT HWY
Practice Address - Street 2:
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1445
Practice Address - Country:US
Practice Address - Phone:716-688-9035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI062443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist