Provider Demographics
NPI:1861548166
Name:FRANCO, MARIA MONTILLA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MONTILLA
Last Name:FRANCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:LOURDES
Other - Last Name:FRANCO-LIPAT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:68 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4318
Mailing Address - Country:US
Mailing Address - Phone:973-893-8076
Mailing Address - Fax:
Practice Address - Street 1:935 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2731
Practice Address - Country:US
Practice Address - Phone:201-478-5800
Practice Address - Fax:201-478-5823
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04957400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3794601Medicaid
F78923Medicare UPIN