Provider Demographics
NPI:1013151356
Name:MONFORTE-DITORE, MARIANN JAYE (RN)
Entity Type:Individual
Prefix:MS
First Name:MARIANN
Middle Name:JAYE
Last Name:MONFORTE-DITORE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 HILLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3308
Mailing Address - Country:US
Mailing Address - Phone:718-761-7023
Mailing Address - Fax:
Practice Address - Street 1:256 HILLMAN AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3308
Practice Address - Country:US
Practice Address - Phone:718-761-7023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY604850-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse