Individual
DR. LORETA MONTOLO UY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
66 SOMME ST, NEWARK, NJ 07105-3612
(973) 589-7337
(973) 589-1905
Mailing address
66 SOMME ST, NEWARK, NJ 07105-3612
(973) 589-7337
(973) 589-1905
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
25MA05504900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA05504900
MEDICAL LICENSE
NJ
05
—
3438708
—
NJ
Enumeration date
07/13/2006
Last updated
11/18/2011
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