Individual
ALEJANDRO REVILLA MONTAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4422 3RD AVE, BRONX, NY 10457-2545
(718) 960-9000
Mailing address
2449 CAMBRELENG AVE APT 3B, BRONX, NY 10458-6524
(646) 204-0833
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
324296
NY
Other
Enumeration date
07/08/2020
Last updated
07/28/2023
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