Healthcare Provider Details

I. General information

NPI: 1558698498
Provider Name (Legal Business Name): MOUNT SINAI SCHOOL OF MEDICINE DEPARTMENT OF ORTHOPAEDIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 HACKENSACK AVE 2ND FLOOR
HACKENSACK NJ
07601-6319
US

IV. Provider business mailing address

5 E 98TH ST
NEW YORK NY
10029-6501
US

V. Phone/Fax

Practice location:
  • Phone: 201-343-1717
  • Fax:
Mailing address:
  • Phone: 212-241-6980
  • Fax: 212-534-6091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. DOUGLAS JABS
Title or Position: CEO
Credential: M.D. M.B.A
Phone: 212-241-6980