Gina Montanero
Individual provider Active NPI Pharmacist · Mantua, NJ
NPI 1124488564 · NPPES record last updated Feb 27, 2016
Key facts
- NPI
- 1124488564
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28RI03281900 (NJ)
- Practice address
- 165 Victoria Ave
Mantua, NJ 08051-1183 - Phone
- (610) 417-5719
- NPI assigned
- Feb 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03281900 | NJ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03281900 | NJ | Yes |
Addresses
Primary practice location
165 Victoria Ave
Mantua, NJ 08051-1183
Mailing address
165 Victoria Ave
Mantua, NJ 08051-1183
Phone (610) 417-5719
Other providers in Mantua, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.