Healthcare Provider Details

I. General information

NPI: 1588857528
Provider Name (Legal Business Name): MOUNT SINAI SCHOOL OF MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 E 98TH ST 14TH FLR
NEW YORK NY
10029-6501
US

IV. Provider business mailing address

PO BOX 13337
NEWARK NJ
07101-3337
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-5429
  • Fax: 212-348-6158
Mailing address:
  • Phone: 212-352-3856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080T0004X
TaxonomyPediatric Transplant Hepatology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DOUGLASS A JABS
Title or Position: CEO FACULTY PRACTICE ASSOCIATES
Credential: M.D., M.B.A.
Phone: 212-241-6752