Organization
MONTEFIORE MEDICAL CENTER
Active
Other names
MMC PS/MS 004
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M PREOLO (SENIOR DIRECTOR, CREDENTIALING)
(914) 608-5063
Entity
Organization
Contact information
Practice address
1701 FULTON AVE, BRONX, NY 10457-7546
(718) 292-0578
Mailing address
100 CORPORATE DR STE 100, YONKERS, NY 10701-6807
(914) 378-6148
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/12/2025
Last updated
03/12/2025
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