| Doctor Name: | VICKI C MONTICELLO |
| NPI Number: | 1114084928 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 333082 |
| Business Practice Address: | 1302 E Main St Endicott, NY - 137605430 |
| Business Phone Number: | 6077547171 |
| Business Fax Number: | 6077540290 |
| Mailing Address: | 58 Lusk St, JOHNSON CITY |
| State: | NY |
| Postal Code: | 137902541 |
| Phone Number: | 6077636293 |
| Fax Number: | 6077636717 |
| NPI Enumeration Date: | 01/02/2007 |
| NPI Last Update Date: | 03/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 333082 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |