Healthcare Provider Details

I. General information

NPI: 1013152453
Provider Name (Legal Business Name): MT. SINAI MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL BOX # 1495
NEW YORK NY
10029-6500
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL BOX # 1495
NEW YORK NY
10029-6500
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-5566
  • Fax: 212-876-5533
Mailing address:
  • Phone: 212-241-5566
  • Fax: 212-876-5533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number301514
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number340245
License Number StateNY

VIII. Authorized Official

Name: SUSAN DAVIS
Title or Position: DIRECTOR OF NURSING/MEDICINE
Credential: RN
Phone: 212-241-8095