Healthcare Provider Details

I. General information

NPI: 1780358804
Provider Name (Legal Business Name): MONTEFIORE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 08/03/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 EASTCHESTER RD
BRONX NY
10469-5947
US

IV. Provider business mailing address

CMO PROVIDER INFORMATION 100 CORPORATE DRIVE, SUITE 100
YONKERS NY
10701
US

V. Phone/Fax

Practice location:
  • Phone: 718-708-5470
  • Fax:
Mailing address:
  • Phone: 914-377-4772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL G. DOWLING
Title or Position: VP
Credential:
Phone: 914-377-4668