Healthcare Provider Details

I. General information

NPI: 1740522556
Provider Name (Legal Business Name): JONATHAN MICHAEL MADEK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2013
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL
NEW YORK NY
10029-6504
US

IV. Provider business mailing address

ANESTHESIOLOGY DEPARTMENT OF MOUNT SINAI PO BOX 28082
NEW YORK NY
10087-5024
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-6500
  • Fax:
Mailing address:
  • Phone: 212-987-3100
  • Fax: 212-241-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number288160
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: