Healthcare Provider Details

I. General information

NPI: 1487325585
Provider Name (Legal Business Name): MONTEFIORE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 THEODORE FREMD AVE STE 104
RYE NY
10580-1411
US

IV. Provider business mailing address

100 CORPORATE DR STE 100
YONKERS NY
10701-6807
US

V. Phone/Fax

Practice location:
  • Phone: 914-921-6061
  • Fax: 914-921-6075
Mailing address:
  • Phone: 914-377-4772
  • 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: MICHAEL G. DOWLING
Title or Position: VP
Credential:
Phone: 914-377-4668