Provider Demographics
NPI:1811293848
Name:MONTALBO, HENA M (RPH)
Entity type:Individual
Prefix:MRS
First Name:HENA
Middle Name:M
Last Name:MONTALBO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90-18 242 ST
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426
Mailing Address - Country:US
Mailing Address - Phone:718-962-2498
Mailing Address - Fax:
Practice Address - Street 1:90-18 242 ST
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426
Practice Address - Country:US
Practice Address - Phone:718-962-2498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist