Provider Demographics
NPI:1881885002
Name:MONTALTO, BARRY J (TD-3197)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:J
Last Name:MONTALTO
Suffix:
Gender:M
Credentials:TD-3197
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1833
Mailing Address - Country:US
Mailing Address - Phone:732-321-2020
Mailing Address - Fax:732-321-0236
Practice Address - Street 1:406 MAIN ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1833
Practice Address - Country:US
Practice Address - Phone:732-321-2020
Practice Address - Fax:732-321-0236
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTD-3197156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician