Basic Information
| Provider Information | |||||||||
| NPI: | 1063435709 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MT. SINAI SCHOOL OF MEDICINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 E 98TH ST FL 5 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100296501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122419065 | ||||||||
| FaxNumber: | 2129871197 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 GUSTAVE L LEVY PLACE | ||||||||
| Address2: | BOX 1048 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122419065 | ||||||||
| FaxNumber: | 2129871197 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 01/05/2010 | ||||||||
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| AuthorizedOfficialLastName: | JABS | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2126599530 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 141913 | NY | Y | Hospitals | General Acute Care Hospital |
No ID Information.