Provider Demographics
NPI:1861033474
Name:MONTEMARANO, MICHAEL A (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:MONTEMARANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MEDICAL CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2300
Mailing Address - Country:US
Mailing Address - Phone:609-653-3500
Mailing Address - Fax:
Practice Address - Street 1:1 E. NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2300
Practice Address - Country:US
Practice Address - Phone:609-653-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11738800208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist