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General NPI Number Information
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NPI Number | 1427493113
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Entity Type | Organization
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Legal Business Name | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 1468 MADISON AVE FL 3
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City | NEW YORK
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State | NY
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Zip | 10029-6508
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Country | US
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Telephone | 888-702-0630
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Fax |
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Provider Business Mailing Address
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Address Line | 150 EAST 42ND STREET 10TH FL.
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City | NEW YORK
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State | NY
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Zip | 10017-5626
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Country | US
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Telephone | 646-605-8119
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Fax | 646-605-3029
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Authorized Official
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Title or Position | VICE PRESIDENT, CBO DIRECTOR,
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Name | MRS. CRYSTAL MACNEILL
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Credential |
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Telephone | 646-605-8112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State | NY
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