Basic Information
| Provider Information | |||||||||
| NPI: | 1194863381 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MONTEAU | ||||||||
| FirstName: | LUCIEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RPA-C, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 622 W 168TH ST PH 137 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100323720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129392250 | ||||||||
| FaxNumber: | 2129394991 | ||||||||
| Practice Location | |||||||||
| Address1: | 154 N 7TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112492910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184142013 | ||||||||
| FaxNumber: | 7184142015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2007 | ||||||||
| LastUpdateDate: | 11/23/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 003880 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.