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General NPI Number Information
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NPI Number | 1477168870
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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 | 09/11/2020
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 111 E 210TH ST
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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 | 718-920-4321
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Fax |
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Provider Business Mailing Address
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Address Line | 555 S BROADWAY BLDG A ROOM A1 R41
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City | TARRYTOWN
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State | NY
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Zip | 10591-6301
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Country | US
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Telephone | 917-289-2722
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Fax |
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Authorized Official
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Title or Position | ASSISTANT VICE PRESIDENT
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Name | RANDI L KOHN
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Credential |
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Telephone | 718-920-6080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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