MEDICARE: MONTEFIORE MEDICAL CENTER

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	207RX0202X	Medical Oncology Physician

General Provider Information

NPI Number	:	1720484769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTEFIORE MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1624 CROSBY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5201
Country	:	US
Telephone Number	:	718-822-2138
Fax Number	:

Provider Business Practice Location Address
First Line	:	1624 CROSBY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5201
Country	:	US
Telephone Number	:	718-822-2138
Fax Number	:

Authorized Official
Title or Position	:	CHIEF ADMIN OFFICER
Name	:	MICHAEL G. DOWLING
Credential	:
Telephone Number	:	914-377-4668

Provider Enumeration Date	:	11/18/2014
Last Update Date	:	11/18/2014

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Directions to “MONTEFIORE MEDICAL CENTER ” Practice Location

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