Active NPI
Children'S Hospital at Montefiore
- Registered Dietitian
- Bronx, NY
National Provider Identifier
1033958350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- CHILDREN'S HOSPITAL AT MONTEFIORE
- Practice address
- 111 E 210TH St
Bronx, NY 10467-2401 - Phone
- (718) 920-4321
- NPI assigned
- May 24, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Monika Gorczyca, CPCS
- Title
- Credentialing Specialist
- Phone
- (718) 741-2487
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary | ||
| Local Education Agency (LEA) | 251300000X |
Addresses
Primary practice location
111 E 210TH St
Bronx, NY 10467-2401
Mailing address
3360 Wallace Ave FL 2
Bronx, NY 10467-6217
Phone (631) 949-5173
Other practice location 1
3415 Bainbridge Ave
Bronx, NY 10467-2403
Phone (718) 741-2426
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00888239 | Medicaid | NY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716508800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1717372800000",
"number": "1033958350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3360 WALLACE AVE FL 2",
"city": "BRONX",
"state": "NY",
"postal_code": "104676217",
"telephone_number": "631-949-5173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E 210TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104672401",
"telephone_number": "718-920-4321"
}
],
"practiceLocations": [
{
"address_1": "3415 Bainbridge Ave",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104672403",
"country_code": "US",
"telephone_number": "718-741-2426",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CHILDREN'S HOSPITAL AT MONTEFIORE",
"organizational_subpart": "NO",
"enumeration_date": "2024-05-24",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A",
"authorized_official_last_name": "GORCZYCA",
"authorized_official_first_name": "MONIKA",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "718-741-2487",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "CPCS"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
},
{
"code": "251300000X",
"taxonomy_group": "",
"desc": "Local Education Agency (LEA)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00888239",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.