Provider Demographics
NPI: | 1164725156 |
---|---|
Name: | MOUNT SINAI SCHOOL OF MEDICINE |
Entity type: | Organization |
Organization Name: | MOUNT SINAI SCHOOL OF MEDICINE |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DOUGLAS |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | JABS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD, MBA |
Authorized Official - Phone: | 212-241-6752 |
Mailing Address - Street 1: | 1 GUSTAVE L LEVY PL |
Mailing Address - Street 2: | BOX 3000 |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10029-6574 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 212-987-3100 |
Mailing Address - Fax: | 212-731-5210 |
Practice Address - Street 1: | ONE GUSTAVE L.LEVY PLACE |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10029-6574 |
Practice Address - Country: | US |
Practice Address - Phone: | 212-241-4141 |
Practice Address - Fax: | 212-426-5108 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-12-13 |
Last Update Date: | 2010-12-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty |