Provider Demographics
NPI:1841661618
Name:MONFORTE MEDICAL, PLLC
Entity type:Organization
Organization Name:MONFORTE MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARTINHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-420-6460
Mailing Address - Street 1:308A E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4001
Mailing Address - Country:US
Mailing Address - Phone:212-420-4640
Mailing Address - Fax:646-602-1091
Practice Address - Street 1:308A E 15TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4001
Practice Address - Country:US
Practice Address - Phone:212-420-4640
Practice Address - Fax:646-602-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty