Healthcare Provider Details

I. General information

NPI: 1023274248
Provider Name (Legal Business Name): MARIE-LOUISE CLAIRE VACHON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2008
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 EAST 98TH STREET 11TH FLOOR MOUNT SINAI MEDICAL CENTER (FACULTY PRACTICE ASSOC/FPA)
NEW YORK NY
10029-6574
US

IV. Provider business mailing address

PO BOX 1123 MOUNT SINAI SCHOOL OF MEDICINE - ONE GUSTAVE L. LEVY PL
NEW YORK NY
10029-6574
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-7270
  • Fax: 212-241-4465
Mailing address:
  • Phone: 917-566-0580
  • Fax: 212-241-4465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number462842
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: