1720295215 NPI number — MOUNT SINAI SCHOOL OF MEDICINE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720295215 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:
Provider Other Organization Name Type Code:
6
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:
1720295215
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 GUSTAVE L LEVY PL
Provider Second Line Business Mailing Address:
BOX 1497
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10029-6500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-241-3055
Provider Business Mailing Address Fax Number:
212-241-9467

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1428 MADISON AVE
Provider Second Line Business Practice Location Address:
SECOND FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10029-6508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-241-7518
Provider Business Practice Location Address Fax Number:
212-241-9467
Provider Enumeration Date:
05/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DESNICK
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
J
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
212-659-6700

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  PFI 3516 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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