Healthcare Provider Details

I. General information

NPI: 1245052448
Provider Name (Legal Business Name): MONTEFIORE NEW ROCHELLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 PELHAM PKWY S
BRONX NY
10461-1042
US

IV. Provider business mailing address

100 CORPORATE DR
YONKERS NY
10701-6807
US

V. Phone/Fax

Practice location:
  • Phone: 718-824-2200
  • Fax:
Mailing address:
  • Phone: 914-378-6148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JESSICA N VARONA
Title or Position: SENIOR APP ANALYST
Credential:
Phone: 914-378-6148