Provider Demographics
NPI:1720146715
Name:MONTALBANO, ROBERT PATRICK (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:PATRICK
Last Name:MONTALBANO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 CUPSAW AVE
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2947
Mailing Address - Country:US
Mailing Address - Phone:201-755-5439
Mailing Address - Fax:
Practice Address - Street 1:407 CEDAR LN
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-1708
Practice Address - Country:US
Practice Address - Phone:201-894-9900
Practice Address - Fax:201-894-9951
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00971900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ110820Medicare PIN