Provider Demographics
NPI:1295885994
Name:MONTALVO, ANNABEL (BS CEIS CIMI)
Entity type:Individual
Prefix:MS
First Name:ANNABEL
Middle Name:
Last Name:MONTALVO
Suffix:
Gender:F
Credentials:BS CEIS CIMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 WEST BRITANNIA ST
Mailing Address - Street 2:#2A
Mailing Address - City:TAUTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780
Mailing Address - Country:US
Mailing Address - Phone:617-538-3259
Mailing Address - Fax:
Practice Address - Street 1:1115 WEST CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:508-559-0473
Practice Address - Fax:508-427-5361
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program