Provider Demographics
NPI:1871859660
Name:MONTEFIORE MEDICAL CENTER
Entity Type:Organization
Organization Name:MONTEFIORE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOUSESTAFF
Authorized Official - Prefix:
Authorized Official - First Name:ISLAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-366-2583
Mailing Address - Street 1:1220 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24504-1844
Mailing Address - Country:US
Mailing Address - Phone:727-366-2583
Mailing Address - Fax:
Practice Address - Street 1:1220 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-1844
Practice Address - Country:US
Practice Address - Phone:727-366-2583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital