Healthcare Provider Details

I. General information

NPI: 1336878651
Provider Name (Legal Business Name): MOUNT SINAI SCHOOL OF MEDICINE OF NEW YORK UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

984 N BROADWAY STE 306
YONKERS NY
10701-1308
US

IV. Provider business mailing address

984 N BROADWAY STE 306
YONKERS NY
10701-1308
US

V. Phone/Fax

Practice location:
  • Phone: 914-369-1700
  • Fax:
Mailing address:
  • Phone: 914-369-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: PUNITA DARJI
Title or Position: FINANCE MANAGER
Credential:
Phone: 646-634-9814