Provider Demographics
NPI:1184167207
Name:MONTAGNARO, KATERINA
Entity type:Individual
Prefix:
First Name:KATERINA
Middle Name:
Last Name:MONTAGNARO
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 1:77 WORTH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3411
Mailing Address - Country:US
Mailing Address - Phone:212-257-6900
Mailing Address - Fax:917-591-9322
Practice Address - Street 1:77 WORTH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3411
Practice Address - Country:US
Practice Address - Phone:212-257-6900
Practice Address - Fax:917-591-9322
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY75014150174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist