1306242680 NPI number — ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Table of content: (NPI 1306242680)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306242680 NPI number — ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
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:
GENERAL MEDICAL ASSOCIATES OF MOUNT SINAI
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:
1306242680
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 7TH AVE
Provider Second Line Business Mailing Address:
8TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10018-4502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-731-6870
Provider Business Mailing Address Fax Number:
212-731-6788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 UNION SQUARE EAST
Provider Second Line Business Practice Location Address:
SUITE 3G, 3H, 3J
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-844-8100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2014

Additional Information

Authorized Official

Authorized Official Last Name:
MACNEILL
Authorized Official First Name:
CRYSTAL
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT, CBO DIRECTOR
Authorized Official Telephone Number:
212-731-6802

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com