1447274865 NPI number — MOUNT SINAI SCHOOL OF MEDICINE

Table of content: (NPI 1447274865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447274865 NPI number — MOUNT SINAI SCHOOL OF MEDICINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOUNT SINAI SCHOOL OF MEDICINE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MOUNT SINAI RADIATION ONCOLOGY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447274865
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 12097
Provider Second Line Business Mailing Address:
515 UNION BOULEVARD
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07101-5097
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-241-0025
Provider Business Mailing Address Fax Number:
212-987-2468

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1184 5TH AVE
Provider Second Line Business Practice Location Address:
BOX 1236
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10029-6503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-241-0025
Provider Business Practice Location Address Fax Number:
212-987-2468
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JABS
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
CEO FPA ASSOCIATES
Authorized Official Telephone Number:
212-241-6752

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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