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General NPI Number Information
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NPI Number | 1902523251
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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 | 10/26/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 415 10TH AVENUE
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City | NEW YORK
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State | NY
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Zip | 10001
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Country | US
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Telephone | 646-819-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 150 E 42ND ST
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City | NEW YORK
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State | NY
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Zip | 10017-5612
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Country | US
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Telephone | 646-605-8119
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | EDWARD A PETERSON
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Credential |
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Telephone | 646-605-8145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103T00000X
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Taxonomy Name | Psychologist
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #6
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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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