Montijo, Iris A
Montijo, Iris A is an individual health care provider with primary practice located at 637 Washington St , Dorchester MA 02124-3510. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Montijo, Iris A can be contacted via phone (617) 825-9660.Contact Information
Primary practice address
637 Washington St
Dorchester MA 02124-3510
Phone: (617) 825-9660
Fax: (617) 288-7898
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | RN206927 | Massachusetts |
Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | RN206927 | Massachusetts |
Profile Details
NPI number | 1871754390 |
---|---|
LBN Legal business name | Montijo, Iris A |
Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 18th, 2008 |
Last updated | Dec 11th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1871754390 | NPPES |
Massachusetts | MEDICAID | 110091560A |
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