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General NPI Number Information
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NPI Number | 1558627844
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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 | 04/11/2012
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 5 EAST 98 STREET 7TH FLOOR
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City | NEWYORK
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State | NY
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Zip | 10029-6511
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Country | US
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Telephone | 212-241-4572
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Fax | 212-241-2542
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Provider Business Mailing Address
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Address Line | PO BOX 28082
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City | NEW YORK
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State | NY
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Zip | 10087-8082
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Country | US
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Telephone | 212-987-3100
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Fax | 646-605-3029
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Authorized Official
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Title or Position | CBO DIRECTOR, VICE PRESIDENT
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Name | 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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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