Healthcare Provider Details

I. General information

NPI: 1811013824
Provider Name (Legal Business Name): MONTEFIORE MEDICAL CENTER JACK D WEILER HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 EASTCHESTER RD
BRONX NY
10461-2301
US

IV. Provider business mailing address

1825 EASTCHESTER RD
BRONX NY
10461-2301
US

V. Phone/Fax

Practice location:
  • Phone: 718-904-2838
  • Fax:
Mailing address:
  • Phone: 718-904-2838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number012551
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number012551
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number012551
License Number StateNY

VIII. Authorized Official

Name: FRANK P SOSNOWSKI
Title or Position: DIRECTOR
Credential: RPH
Phone: 718-920-4529