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General NPI Number Information
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NPI Number | 1801147301
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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 | 09/24/2012
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Last Update Date | 09/24/2012
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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 | 718-920-8840
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Fax |
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Provider Business Mailing Address
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Address Line | 43 48TH ST APT 1
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City | WEEHAWKEN
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State | NJ
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Zip | 07086-7227
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Country | US
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Telephone | 570-977-1056
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MS. KIMBERLY OFOEGBU
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Credential | P.A.
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Telephone | 570-977-1056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number | 015809
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License Number State | NY
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