MEDICARE: MONTEFIORE NORTH AMBULATORY CARE CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QC1500X	Community Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144228099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTEFIORE NORTH AMBULATORY CARE CENTER INC

Provider Business Mailing Address
First Line	:	100 CORPORATE DR
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10701-6807
Country	:	US
Telephone Number	:	914-378-6163
Fax Number	:

Provider Business Practice Location Address
First Line	:	4234 BRONX BLVD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2611
Country	:	US
Telephone Number	:	347-341-4300
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PROVIDER SERVICES
Name	:	MR. MICHAEL DOWLING
Credential	:
Telephone Number	:	914-377-4668

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	02/22/2016

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