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Individual

IVETH VIVIANA MONTANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
825 W END AVE, NEW YORK, NY 10025-5349
(646) 353-2405
(212) 622-9222
Mailing address
825 W END AVE, NEW YORK, NY 10025-5349
(646) 353-2405
(212) 622-9222

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
06/25/2013
Last updated
06/25/2013
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