# MONTEFIORE MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MONTEFIORE MEDICAL CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477168870
- **Legal business name:** MONTEFIORE MEDICAL CENTER
- **Authorized official:** RANDI L KOHN (ASSISTANT VICE PRESIDENT)
- **Authorized official phone:** (718) 920-6080

## Contact information

- **Practice address:** 111 E 210TH ST, BRONX, NY 10467-2401
- **Practice address phone:** (718) 920-4321
- **Mailing address:** 555 S BROADWAY, BLDG A ROOM A1 R41, TARRYTOWN, NY 10591-6301
- **Mailing address phone:** (917) 289-2722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/11/2020
- **Last updated:** 09/11/2020