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1669854824 NPI number — NORTH SHORE MEDICAL GROUP OF THE MOUNT SINAI SCHOOL OF MEDICINE

NPI Number: 1669854824
Health Care Provider/Practitioner: NORTH SHORE MEDICAL GROUP OF THE MOUNT SINAI SCHOOL OF MEDICINE

Information about “1669854824” NPI (NORTH SHORE MEDICAL GROUP OF THE MOUNT SINAI SCHOOL OF MEDICINE) exists in 1669854824 in HTML format HTML  |  1669854824 in plain Text format TXT  |  1669854824 in PDF (Portable Document Format) PDF  |  1669854824 in an XML format XML  formats.

NPI Number : 1669854824 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669854824",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "MOUNT SINAI MEDICAL CENTER",
    "ParentOrgTIN": null,
    "OrgName": "NORTH SHORE MEDICAL GROUP OF THE MOUNT SINAI SCHOOL OF MEDICINE",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1436 BROADWAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HEWLETT",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11557-1405",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "929-210-6570",
    "MailingAddressFaxNumber": "929-210-6571",
    "FirstLinePracticeLocationAddress": "1436 BROADWAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HEWLETT",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11557-1405",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "929-210-6570",
    "PracticeLocationAddressFaxNumber": "929-210-6571",
    "EnumerationDate": "06/24/2015",
    "LastUpdateDate": "06/24/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GRESHAM",
    "AuthorizedOfficialFirstName": "ALICIA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "VP NETWORK OPERATIONS",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "212-659-9038",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2080A0000X",
          "TaxonomyName": "Pediatric Adolescent Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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