Provider Demographics
NPI:1548647282
Name:MONTEFIORE MEDICAL CENTER
Entity type:Organization
Organization Name:MONTEFIORE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR, HOUSE STAFF OFF
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTICE
Authorized Official - Middle Name:
Authorized Official - Last Name:GABA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-920-4093
Mailing Address - Street 1:111 E 210TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-4093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NW0100XHospitalsGeneral Acute Care HospitalWomen