Individual
ANDRE PATRICK DE MONTAGNAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4210 COLDEN ST, SUITE 209, FLUSHING, NY 11355-4845
(718) 321-8910
(718) 321-9022
Mailing address
4210 COLDEN ST, SUITE 209, FLUSHING, NY 11355-4845
(718) 321-8910
(718) 321-9022
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
016579
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02285418
—
NY
Enumeration date
05/08/2007
Last updated
02/05/2014
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