MEDICARE: MONTEFIORE NYACK HOSPITAL

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	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1679044002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTEFIORE NYACK HOSPITAL

Provider Business Mailing Address
First Line	:	160 N MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-1998
Country	:	US
Telephone Number	:	845-348-6682
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 N MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-1998
Country	:	US
Telephone Number	:	845-348-6682
Fax Number	:

Authorized Official
Title or Position	:	CDM/BILLING MANAGER
Name	:	JOSEPHINE S CAPO
Credential	:
Telephone Number	:	845-348-6682

Provider Enumeration Date	:	12/11/2018
Last Update Date	:	12/11/2018

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Directions to “MONTEFIORE NYACK HOSPITAL ” Practice Location

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