Provider Demographics
NPI:1447329453
Name:PAULA MONTAGNA, MS, RD, CDN, PLLC
Entity type:Organization
Organization Name:PAULA MONTAGNA, MS, RD, CDN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:MONTAGNA
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:631-288-4994
Mailing Address - Street 1:228 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11978-2049
Mailing Address - Country:US
Mailing Address - Phone:631-288-4994
Mailing Address - Fax:
Practice Address - Street 1:33 MONTAUK HIGHWAY
Practice Address - Street 2:
Practice Address - City:QUOGUE
Practice Address - State:NY
Practice Address - Zip Code:11959
Practice Address - Country:US
Practice Address - Phone:631-563-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002371-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty