Organization Active NPI

Montefiore Medical Center

  • Student Health Clinic/Center
  • Bronx, NY
National Provider Identifier
1841099710
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
MONTEFIORE MEDICAL CENTER
Practice address
1701 Fulton Ave
Bronx, NY 10457-7546
Phone
(718) 292-0578
NPI assigned
Mar 12, 2025
Last updated
Mar 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John M Preolo
Title
Senior Director, Credentialing
Phone
(914) 608-5063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

1701 Fulton Ave
Bronx, NY 10457-7546

Mailing address

100 Corporate Dr Ste 100
Yonkers, NY 10701-6807
Phone (914) 378-6148

Other names 1

  • MMC PS/MS 004 Other name

National Provider Directory

National Provider Directory
Tax ID family
MMC at Icahn House Family Shelter520 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1701 Fulton Ave
Bronx, NY 10457
Phone (718) 292-0578

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1841099710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CORPORATE DR STE 100",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107016807",
            "telephone_number": "914-378-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577546",
            "telephone_number": "718-292-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEFIORE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-12",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "PREOLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, CREDENTIALING",
        "authorized_official_telephone_number": "914-608-5063"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMC PS/MS 004",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.