1598832016 NPI number — DR. EDUARDO MONTES MD

Table of content: DR. EDUARDO MONTES MD (NPI 1598832016)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598832016 NPI number — DR. EDUARDO MONTES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONTES
Provider First Name:
EDUARDO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598832016
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
345 LAKE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UPPER SADDLE RIVER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07458-1751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-236-3910
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8701 BERGENLINE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH BERGEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07047-5252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-861-2442
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  25MA04947900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 18Y81 . This is a "EMPIRE BLUE CROSS BLUE SH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 223105991-001 . This is a "SELF INSURED SERVICES" identifier . This identifiers is of the category "OTHER".
  • Identifier: S53K1 . This is a "EMPIRE BCBSNJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 78022231059910 . This is a "HORIZON BCBSNJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2508202 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 223105991-0003 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: USA899999 . This is a "BLUE SHIELD OF CALIFORNIA" identifier . This identifiers is of the category "OTHER".




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