Provider Demographics
NPI:1740092931
Name:MONTERO, ANTONY
Entity type:Individual
Prefix:
First Name:ANTONY
Middle Name:
Last Name:MONTERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 E 165TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-2531
Mailing Address - Country:US
Mailing Address - Phone:347-717-6256
Mailing Address - Fax:
Practice Address - Street 1:1084 E 165TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-2531
Practice Address - Country:US
Practice Address - Phone:347-717-6256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP119278101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty