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General NPI Number Information
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NPI Number | 1568868834
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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 | 11/13/2014
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | 55 WEST 34TH STREET 1ST FLOOR
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 212-252-6231
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Fax |
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Provider Business Mailing Address
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Address Line | 500 7TH AVE 8TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10018-4502
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Country | US
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Telephone | 212-731-6870
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Fax | 212-731-6788
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Authorized Official
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Title or Position | VICE PRESIDENT, CBO DIRECTOR
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Name | MS. CRYSTAL MACNEILL
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Credential |
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Telephone | 212-731-6802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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