Organization
MARTHA'S VINEYARD ORTHOPEDIC SURGERY AND SPORTS MEDICINE
Active
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
Update your record
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