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General NPI Number Information
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NPI Number | 1417007261
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Entity Type | Individual
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Provider Name | BARRY FOMBERSTEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 600 E 233RD ST
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City | BRONX
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State | NY
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Zip | 10466-2604
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Country | US
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Telephone | 718-920-9168
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Fax | 718-920-9036
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Provider Business Mailing Address
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Address Line | 600 EAST 233RD STREET MONTEFIORE MEDICAL CENTER - NORTH DIVISION
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City | BRONX
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State | NY
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Zip | 10466-2604
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Country | US
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Telephone | 718-920-9168
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Fax | 718-920-9036
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 131884
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License Number State | NY
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