Provider Demographics
NPI:1487164794
Name:ALMONTE, EDWIN M (CM)
Entity type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:M
Last Name:ALMONTE
Suffix:
Gender:M
Credentials:CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:998 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-1576
Mailing Address - Country:US
Mailing Address - Phone:845-582-0337
Mailing Address - Fax:845-582-0928
Practice Address - Street 1:8 LIBRARY PL
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2106
Practice Address - Country:US
Practice Address - Phone:203-300-5070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0001331372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04489341Medicaid