Healthcare Provider Details

I. General information

NPI: 1003158304
Provider Name (Legal Business Name): THE MOUNT SINAI MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 03/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1468 MADISON AVE FL 15 BOX1194 PATHOLOGY RESIDENCY PROGRAM
NEW YORK NY
10029-6508
US

IV. Provider business mailing address

8162 REGENTS RD APT204
SAN DIEGO CA
92122-1370
US

V. Phone/Fax

Practice location:
  • Phone: 409-599-9446
  • Fax:
Mailing address:
  • Phone: 409-599-9446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MS. ALLENE CARTER
Title or Position: RESIDENCY PROGRAM COORDINATOR
Credential:
Phone: 212-241-8014