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General NPI Number Information
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NPI Number | 1033270640
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Entity Type | Organization
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Legal Business Name | MONTEFIORE MEDICAL CENTER
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 871 PROSPECT AVE
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City | BRONX
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State | NY
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Zip | 10459-3913
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Country | US
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Telephone | 718-991-0605
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Fax | 718-991-2931
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Provider Business Mailing Address
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Address Line | 11215 72ND RD APARTMENT 505
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City | FOREST HILLS
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State | NY
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Zip | 11375-4663
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Country | US
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Telephone | 917-705-2710
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Fax |
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. HILDRED MACHUCA
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Credential | D.O.
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Telephone | 718-991-0605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 227890
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License Number State | NY
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