Healthcare Provider Details

I. General information

NPI: 1063435709
Provider Name (Legal Business Name): MT. SINAI SCHOOL OF MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 01/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PLACE BOX 1048
NEW YORK NY
10029
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 212-241-9065
  • Fax: 212-987-1197
Mailing address:
  • Phone: 212-241-9065
  • Fax: 212-987-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number141913
License Number StateNY

VIII. Authorized Official

Name: DR. DOUGLAS A JABS
Title or Position: CEO
Credential: M.D.
Phone: 212-659-9530