Healthcare Provider Details

I. General information

NPI: 1831946359
Provider Name (Legal Business Name): MONTEFIORE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CENTEROCK RD
WEST NYACK NY
10994-2214
US

IV. Provider business mailing address

100 CORPORATE DR STE 100
YONKERS NY
10701-6807
US

V. Phone/Fax

Practice location:
  • Phone: 845-425-0555
  • Fax: 845-953-3211
Mailing address:
  • Phone: 914-378-6148
  • Fax: 914-457-9517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JESSICA VARONA
Title or Position: SENIOR APPLICATIONS ANALYST
Credential:
Phone: 914-378-6148