Provider Demographics
NPI:1740097575
Name:MONTERO, ALBA CRISTAL
Entity type:Individual
Prefix:
First Name:ALBA
Middle Name:CRISTAL
Last Name:MONTERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:792 LIGHT ST
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4635
Mailing Address - Country:US
Mailing Address - Phone:475-257-0436
Mailing Address - Fax:
Practice Address - Street 1:792 LIGHT ST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4635
Practice Address - Country:US
Practice Address - Phone:475-257-0436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT193413163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse