Individual
DR. DANIEL R. MONTELLESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1320 STONY BROOK RD STE 100, STONY BROOK, NY 11790
(631) 941-2273
(631) 941-2501
Mailing address
1320 STONY BROOK ROAD, BLDG D, SUITE 100, STONY BROOK, NY 11790
(631) 941-2273
(631) 941-2501
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
241554
NY
207RI0011X
Interventional Cardiology Physician
Primary
241554
NY
207RI0011X
Interventional Cardiology Physician
241554-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03427332
—
NY
Enumeration date
10/05/2006
Last updated
10/11/2021
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