OrganizationActive
Licking Memorial Professional Corp.
NPI 1649290073 · Geriatric Medicine (Internal Medicine) Physician · Newark, OH
Provider details
- NPI number
- 1649290073
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Robert Montagnese, Executive V.p.(740) 348-4000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
120 Mcmillen Dr
Newark, OH 43055-1809
Phone: (740) 348-7935
Fax: (740) 348-7936
Approximate (ZIP-level) locationGet directions
Mailing address
120 Mcmillen Dr
Newark, OH 43055-1809
Other names (DBA / former)
- Doing business as
- Licking Memorial Geriatric Medicine
Registry dates
- Enumerated
- 2006-07-20
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.