Healthcare Provider Details

I. General information

NPI: 1760720106
Provider Name (Legal Business Name): MONTEFIORE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 01/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

984 N BROADWAY
YONKERS NY
10701-1318
US

IV. Provider business mailing address

984 N BROADWAY
YONKERS NY
10701-1318
US

V. Phone/Fax

Practice location:
  • Phone: 914-965-2060
  • Fax: 914-965-5759
Mailing address:
  • Phone: 914-965-2060
  • Fax: 914-965-5759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GQ DOWLING
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 914-377-4668