Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Montefiore Medical Center

Organization Anesthesiology Physician · NPI 1063525152

Montefiore Medical Center is an Anesthesiology Physician in Bronx, New York. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
15

Practice location Address checks out

111 E 210th St
Bronx, NY 10467-2401
Phone: (914) 378-6021
Fax: (914) 709-0386
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X
Emergency Medicine Physician Taxonomy 207P00000X
Internal Medicine Physician Taxonomy 207R00000X
Nuclear Medicine Physician Taxonomy 207U00000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Ophthalmology Physician Taxonomy 207W00000X
Orthopaedic Surgery Physician Taxonomy 207X00000X
Otolaryngology Physician Taxonomy 207Y00000X
Anatomic Pathology & Clinical Pathology Physician Taxonomy 207ZP0102X
Pediatrics Physician Taxonomy 208000000X
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X
Psychiatry Physician Taxonomy 2084P0800X
Diagnostic Radiology Physician Taxonomy 2085R0202X
Surgery Physician Taxonomy 208600000X
Urology Physician Taxonomy 208800000X

Record details

NPI number1063525152
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMontefiore Medical Center
Authorized official John Preolo — Sr Director Provider Credentialing · (914) 608-5063
Other names Mmc-Faculty Practice
NPI enumeratedAugust 16, 2006
Last updated in NPPESMarch 18, 2025
Certification dateMarch 18, 2025
Mailing address100 Corporate Dr, Mmc-Cmo, Yonkers, NY 10701-6807

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