Organization
MARTHA'S VINEYARD ORTHOPEDIC SURGERY AND SPORTS MEDICINE
Active
Other names
MONTO ORTHOPEDICS
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND ROCCO MONTO M.D. (CEO)
(508) 693-5949
Entity
Organization
Contact information
Practice address
12 COURNOYER ROAD, WEST TISBURY, MA 02575-0547
(508) 693-5949
(508) 693-0319
Mailing address
PO BOX 547, WEST TISBURY, MA 02575-0547
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
225100000X
Physical Therapist
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9703217
—
MA
01
—
AA39271
HARVARD PILGRIM PT GROUP
—
01
—
M17719
BLUE CROSS BLUE SHIELD
MA
01
—
Y61175
BC/BS PT GROUP
MA
Enumeration date
03/24/2006
Last updated
11/25/2007
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