Basic Information
| Provider Information | |||||||||
| NPI: | 1992131320 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MONTEFIORE MOUNT VERNON HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 E 210TH ST | ||||||||
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| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104672401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146648000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12 N 7TH AVE | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105502026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146648000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2013 | ||||||||
| LastUpdateDate: | 02/11/2020 | ||||||||
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| AuthorizedOfficialLastName: | KOHN | ||||||||
| AuthorizedOfficialFirstName: | RANDI | ||||||||
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| AuthorizedOfficialTitleorPosition: | AVP, REGULATORY PLANNING | ||||||||
| AuthorizedOfficialTelephone: | 7189206080 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 02/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 5903001H | NY | N | Hospital Units | Psychiatric Unit | 282N00000X | 5903001H | NY | Y | Hospitals | General Acute Care Hospital |
No ID Information.