Healthcare Provider Details

I. General information

NPI: 1720385297
Provider Name (Legal Business Name): MOUNT SINAI SCHOOL OF MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2011
Last Update Date: 02/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL BOX 1621
NEW YORK NY
10029-6500
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL BOX 1621
NEW YORK NY
10029-6500
US

V. Phone/Fax

Practice location:
  • Phone: 212-731-7906
  • Fax: 212-348-6158
Mailing address:
  • Phone: 212-731-7906
  • Fax: 212-348-6158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DOUGLAS A. JABS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.D., M.B.A.
Phone: 212-241-6752