Basic Information
| Provider Information | |||||||||
| NPI: | 1326311614 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOUNT SINAI DEPARTMENT OF ORTHOPAEDIC SURGERY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 E 98TH ST | ||||||||
| Address2: | BOX 1188 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100296501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122416980 | ||||||||
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| Practice Location | |||||||||
| Address1: | 305 W GRAND AVE | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | MONTVALE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076451813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2013918282 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2012 | ||||||||
| LastUpdateDate: | 02/16/2012 | ||||||||
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| AuthorizedOfficialLastName: | LOTA | ||||||||
| AuthorizedOfficialFirstName: | JANINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 2122411643 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0117X | 238595 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
No ID Information.