Organization
MONTEFIORE MEDICAL CENTER
Active
Other names
Montefiore Community Pharmacy @ Moses
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN W TUCKMAN (DIRECTOR OF PHARMACY)
(718) 920-5194
Entity
Organization
Contact information
Practice address
111 E 210TH ST, FCC BUILDING GROUND FLOOR, BRONX, NY 10467
(718) 920-7869
(718) 654-7690
Mailing address
111 EAST 210 STREET, FCC BUILDING GROUND FLOOR, BRONX, NY 10467-2401
(718) 920-7869
(718) 654-7690
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
024608
NY
3336C0003X
Community/Retail Pharmacy
Primary
024608
NY
3336S0011X
Specialty Pharmacy
024608
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02009598
—
NY
01
—
024608
STATE LICENSE NUMBER
NY
01
—
3310810
NABP NUMBER
NY
Enumeration date
02/28/2007
Last updated
05/28/2019
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