Provider Demographics
NPI:1912234626
Name:MONTANO, NETZI JENYS (NP)
Entity Type:Individual
Prefix:
First Name:NETZI
Middle Name:JENYS
Last Name:MONTANO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 E BROAD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1724
Mailing Address - Country:US
Mailing Address - Phone:585-276-7640
Mailing Address - Fax:585-325-4255
Practice Address - Street 1:454 E BROAD ST STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1724
Practice Address - Country:US
Practice Address - Phone:585-276-7640
Practice Address - Fax:585-325-4255
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY717841163W00000X
NY347759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse