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NPI Code Detail

MEDICARE: MONTEFIORE MEDICAL CENTER

MEDICARE: MONTEFIORE MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician
2207Y00000XOtolaryngology Physician
3208000000XPediatrics Physician
4207ZP0102XAnatomic Pathology & Clinical Pathology Physician
5208100000XPhysical Medicine & Rehabilitation Physician
62084P0800XPsychiatry Physician
72085R0202XDiagnostic Radiology Physician
8208600000XSurgery Physician
9207P00000XEmergency Medicine Physician
10207R00000XInternal Medicine Physician
11207U00000XNuclear Medicine Physician
12207V00000XObstetrics & Gynecology Physician
13207W00000XOphthalmology Physician
14208800000XUrology Physician
15207L00000XAnesthesiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063525152
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONTEFIORE MEDICAL CENTER
Provider Business Mailing Address
First Line : 100 CORPORATE DR
Second Line : MMC-CMO
City : YONKERS
State : NY
Zip : 10701-6807
Country : US
Telephone Number : 917-378-6021
Fax Number : 914-709-0386
Provider Business Practice Location Address
First Line : 111 E 210TH ST
Second Line :
City : BRONX
State : NY
Zip : 10467-2401
Country : US
Telephone Number : 914-378-6021
Fax Number : 914-709-0386
Authorized Official
Title or Position : SR DIRECTOR PROVIDER CREDENTIALING
Name : JOHN M PREOLO
Credential :
Telephone Number : 914-608-5063
Provider Enumeration Date : 08/16/2006
Last Update Date : 03/18/2025

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Directions to “MONTEFIORE MEDICAL CENTER ” Practice Location

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