Basic Information
| Provider Information | |||||||||
| NPI: | 1174628267 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MONSERRATE,OTANO & PIJEM | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 539A CALLE S CUEVAS BUSTAMANTE | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009182681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877650054 | ||||||||
| FaxNumber: | 7878120565 | ||||||||
| Practice Location | |||||||||
| Address1: | 539A CALLE S CUEVAS BUSTAMANTE | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009182681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877650054 | ||||||||
| FaxNumber: | 7878120565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PIJEM | ||||||||
| AuthorizedOfficialFirstName: | ENRIQUE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7877650054 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.