Provider Demographics
NPI:1285384958
Name:MOUNT CARMEL MEDICAL PC
Entity type:Organization
Organization Name:MOUNT CARMEL MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREESH
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-602-4353
Mailing Address - Street 1:5 MARLBORO LN
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-4409
Mailing Address - Country:US
Mailing Address - Phone:914-602-4353
Mailing Address - Fax:
Practice Address - Street 1:5 MARLBORO LN
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-4409
Practice Address - Country:US
Practice Address - Phone:914-602-4353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service