1932802188 NPI number — MRS. JOANNA ELAINE MONTEJAR PANGILINAN MD

Table of content: MRS. JOANNA ELAINE MONTEJAR PANGILINAN MD (NPI 1932802188)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932802188 NPI number — MRS. JOANNA ELAINE MONTEJAR PANGILINAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PANGILINAN
Provider First Name:
JOANNA ELAINE
Provider Middle Name:
MONTEJAR
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MONTEJAR
Provider Other First Name:
JOANNA ELAINE
Provider Other Middle Name:
ESLAO
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932802188
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9817 HORACE HARDING EXPY APT 9F
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORONA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11368-4235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-369-5521
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9817 HORACE HARDING EXPY APT 9F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORONA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11368-4235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-369-5521
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2023

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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