Provider Demographics
NPI:1205948643
Name:DR. MONTANARELLA & ASSOCIATES, PA
Entity type:Organization
Organization Name:DR. MONTANARELLA & ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-624-1638
Mailing Address - Street 1:30 CANTON ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3524
Mailing Address - Country:US
Mailing Address - Phone:603-624-1638
Mailing Address - Fax:603-624-1972
Practice Address - Street 1:30 CANTON ST
Practice Address - Street 2:SUITE 6
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3524
Practice Address - Country:US
Practice Address - Phone:603-624-1638
Practice Address - Fax:603-624-1972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE1287Medicare ID - Type Unspecified