Provider Demographics
NPI:1871782979
Name:MONTEFIORE MEDICAL CENTER
Entity type:Organization
Organization Name:MONTEFIORE MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMILLE
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:718-920-2961
Mailing Address - Street 1:1348 E 59TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4124
Mailing Address - Country:US
Mailing Address - Phone:718-920-2961
Mailing Address - Fax:
Practice Address - Street 1:1348 E 59TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4124
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:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005039282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital