Organization
CHILDREN'S HOSPITAL AT MONTEFIORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONIKA GORCZYCA CPCS (CREDENTIALING SPECIALIST)
(718) 741-2487
Entity
Organization
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
3360 WALLACE AVE FL 2, BRONX, NY 10467-6217
(631) 949-5173
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
251300000X
Local Education Agency (LEA)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00888239
—
NY
Enumeration date
05/24/2024
Last updated
06/03/2024
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