Provider Demographics
NPI:1841060324
Name:MONTO, DESIREE NACOLE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:NACOLE
Last Name:MONTO
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SHERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-3727
Mailing Address - Country:US
Mailing Address - Phone:201-208-4844
Mailing Address - Fax:
Practice Address - Street 1:28 SHERWOOD LN
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-3727
Practice Address - Country:US
Practice Address - Phone:201-208-4844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR16232500163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant