Healthcare Provider Details

I. General information

NPI: 1023028685
Provider Name (Legal Business Name): MOUNT SINAI SCHOOL OF MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 10/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE LEVY PLACE
NEW YORK NY
10029-6574
US

IV. Provider business mailing address

1 GUSTAVE LEVY PLACE- BOX 3000
NEW YORK NY
10029-6574
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-6784
  • Fax: 212-987-6915
Mailing address:
  • Phone: 212-987-3100
  • Fax: 212-731-5220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS A JABS
Title or Position: M.B.A. CEO FPA ASSOCIATES
Credential: M.D.
Phone: 212-241-4739