Healthcare Provider Details

I. General information

NPI: 1780407866
Provider Name (Legal Business Name): MONTEFIORE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 OLD POST RD
BEDFORD NY
10506-1018
US

IV. Provider business mailing address

100 CORPORATE DR STE 100
YONKERS NY
10701-6807
US

V. Phone/Fax

Practice location:
  • Phone: 914-234-4445
  • Fax: 914-234-4446
Mailing address:
  • Phone: 914-378-6148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOHN M PREOLO
Title or Position: SENIOR DIRECTOR PROVIDER CREDENTIAL
Credential:
Phone: 914-608-5063