Individual
KENNETH DALE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
160 E HANOVER AVE, MORRISTOWN, NJ 07960-3150
(973) 538-2334
(973) 538-1297
Mailing address
160 E HANOVER AVE, PO BOX 1446, MORRISTOWN, NJ 07960-3150
(973) 538-2334
(973) 538-1297
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
188735-1
NY
207X00000X
Orthopaedic Surgery Physician
25MA08100000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188735-1
NEW YORK LICENSE
NY
01
—
25MA08100000
NEW JERSEY LICENSE
NJ
Enumeration date
06/15/2006
Last updated
01/14/2010
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