Provider Demographics
NPI:1437662376
Name:MONTESDEOCA, ANA E
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:E
Last Name:MONTESDEOCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 E 201ST ST APT D4
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-2274
Mailing Address - Country:US
Mailing Address - Phone:347-654-2608
Mailing Address - Fax:
Practice Address - Street 1:367 E 201ST ST APT D4
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-2274
Practice Address - Country:US
Practice Address - Phone:347-654-2608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-14
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator