Healthcare Provider Details

I. General information

NPI: 1982388211
Provider Name (Legal Business Name): MONTEFIORE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 MCLEAN AVE
YONKERS NY
10704-3855
US

IV. Provider business mailing address

100 CORPORATE DR STE 100
YONKERS NY
10701-6807
US

V. Phone/Fax

Practice location:
  • Phone: 914-965-1453
  • Fax: 914-965-1836
Mailing address:
  • Phone: 914-377-4722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL G DOELING
Title or Position: VP
Credential:
Phone: 914-377-4668