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General NPI Number Information
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NPI Number | 1942588660
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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 | 07/29/2011
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Last Update Date | 07/29/2011
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Provider Practice Location Address
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Address Line | 197 VALENTINE LN # 1F
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City | YONKERS
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State | NY
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Zip | 10705-3601
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Country | US
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Telephone | 718-913-6750
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Fax |
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Provider Business Mailing Address
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Address Line | 197 VALENTINE LN, APT 1F
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City | YONKERS
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State | NY
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Zip | 10705
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Country | US
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Telephone | 718-913-6750
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | TYR WILBANKS
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Credential | MD
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Telephone | 718-920-9143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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