Provider Demographics
NPI:1255664991
Name:MONTEFIORE MEDICAL CENTER
Entity Type:Organization
Organization Name:MONTEFIORE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:BONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-706-3039
Mailing Address - Street 1:295 PARK AVE S
Mailing Address - Street 2:APARTMENT 14K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4503
Mailing Address - Country:US
Mailing Address - Phone:315-706-3039
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:SILVER ZONE 6TH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-2961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital