Provider Demographics
NPI:1740997170
Name:MONTOYA, LYNN JOAN
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:JOAN
Last Name:MONTOYA
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 1:50 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-2010
Mailing Address - Country:US
Mailing Address - Phone:718-536-5299
Mailing Address - Fax:
Practice Address - Street 1:50 AVENUE A
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-2010
Practice Address - Country:US
Practice Address - Phone:718-536-5299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist