Montano Wellness Llc | |
160 West St Ste 1a Cromwell CT 06416-2441 | |
(860) 632-0144 | |
(860) 632-7882 |
Full Name | Montano Wellness Llc |
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Speciality | Internal Medicine |
Location | 160 West St Ste 1a, Cromwell, Connecticut |
Authorized Official Name and Position | Charles Brendan Montano (OWNER, MEDICAL DIRECTOR) |
Authorized Official Contact | 8606320144 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Montano Wellness Llc 160 West St Ste 1a Cromwell CT 06416-2441 Ph: (860) 632-0144 | Montano Wellness Llc 160 West St Ste 1a Cromwell CT 06416-2441 Ph: (860) 632-0144 |
NPI Number | 1740776954 |
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Provider Enumeration Date | 07/11/2018 |
Last Update Date | 07/11/2018 |
Medicare PECOS PAC ID | 6406106954 |
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Medicare Enrollment ID | O20180905001099 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740776954 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 016871 (Connecticut) | Primary |
Provider Name | Charles Montano |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1487673208 PECOS PAC ID: 4981752805 Enrollment ID: I20090504000426 |
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