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Organization

MONTEFIORE MEDICAL CENTER

Active
Parent organization
MONTEFIORE MEDICAL CENTER
Other names
MMC-Faculty Practice
Organization subpart
Yes

Provider details

NPI number
Legal business name
MONTEFIORE MEDICAL CENTER
Authorized official
JOHN M PREOLO (SR DIRECTOR PROVIDER CREDENTIALING)
(914) 608-5063
Entity
Organization

Contact information

Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(914) 378-6021
(914) 709-0386
Mailing address
100 CORPORATE DR, MMC-CMO, YONKERS, NY 10701-6807
(917) 378-6021
(914) 709-0386

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
207P00000X
Emergency Medicine Physician
207R00000X
Internal Medicine Physician
207U00000X
Nuclear Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
207W00000X
Ophthalmology Physician
207X00000X
Orthopaedic Surgery Physician
207Y00000X
Otolaryngology Physician
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
208000000X
Pediatrics Physician
208100000X
Physical Medicine & Rehabilitation Physician
2084P0800X
Psychiatry Physician
2085R0202X
Diagnostic Radiology Physician
208600000X
Surgery Physician
208800000X
Urology Physician

Other

Enumeration date
08/16/2006
Last updated
03/18/2025
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