Provider Demographics
NPI:1649253618
Name:MONTALTO, JOSEPH G (MSPT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:G
Last Name:MONTALTO
Suffix:
Gender:M
Credentials:MSPT
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Mailing Address - Street 1:123 SOUTH ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-2251
Mailing Address - Country:US
Mailing Address - Phone:516-624-6739
Mailing Address - Fax:516-624-6829
Practice Address - Street 1:123 SOUTH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-2251
Practice Address - Country:US
Practice Address - Phone:516-624-6739
Practice Address - Fax:516-624-6829
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2017-02-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0190711225100000X
NY005925171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQQ4512Medicare PIN