Healthcare Provider Details

I. General information

NPI: 1164689360
Provider Name (Legal Business Name): MONTEFIORE MED CTR-LUBIN REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 EASTCHESTER RD
BRONX NY
10461-2301
US

IV. Provider business mailing address

100 CORPORATE DR CMO
YONKERS NY
10701-6807
US

V. Phone/Fax

Practice location:
  • Phone: 914-378-6163
  • Fax:
Mailing address:
  • Phone: 914-377-4722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL G DOWLING
Title or Position: DIRECTOR OF PROVIDER SERVICES
Credential:
Phone: 914-377-4668