# NANCY J MOONTASRI MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124931472
- **Authorized official:** DR. NANCY J MOONTASRI MD (SOLE MEMBER/OWNER)
- **Authorized official phone:** (551) 278-9776

## Contact information

- **Practice address:** 106 PROSPECT ST STE 2, RIDGEWOOD, NJ 07450-4433
- **Practice address phone:** (551) 278-9776
- **Practice address fax:** (551) 300-1306
- **Mailing address:** 1 MARS CT STE 1, BOONTON TWP, NJ 07005-2422
- **Mailing address phone:** (551) 278-9776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |

## Other

- **Enumeration date:** 09/28/2026
- **Last updated:** 10/05/2026