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General NPI Number Information
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NPI Number | 1083975940
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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 | 06/06/2012
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 111 E 210TH ST FL 4
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City | BRONX
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State | NY
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Zip | 10467-2401
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Country | US
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Telephone | 718-920-5595
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Fax |
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Provider Business Mailing Address
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Address Line | 111 E 210TH ST FL 4
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City | BRONX
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State | NY
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Zip | 10467-2401
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Country | US
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Telephone | 718-920-5595
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANGER
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Name | MISS SHEILA FRANCIS
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Credential |
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Telephone | 718-920-5292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | COLOA1
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License Number State | NY
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