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General NPI Number Information
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NPI Number | 1265809255
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Entity Type | Organization
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Legal Business Name | MOUNT SINAI HOSPITAL
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Dates
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Enumeration Date | 08/26/2015
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 355 BROADWAY
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-1642
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Country | US
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Telephone | 516-592-2912
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Fax |
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Provider Business Mailing Address
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Address Line | 355 BROADWAY
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-1642
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Country | US
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Telephone | 516-592-2912
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MR. MICHAEL J TAMBORINO
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Credential | PA
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Telephone | 516-592-2912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 018951
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License Number State | NY
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