MEDICARE: MOUNT SINAI DIAGNOSTIC AND TREATMENT CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center		NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669476156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNT SINAI DIAGNOSTIC AND TREATMENT CENTER

Provider Business Mailing Address
First Line	:	1 GUSTAVE L LEVY PL
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6500
Country	:	US
Telephone Number	:	212-241-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 GUSTAVE L LEVY PL
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6500
Country	:	US
Telephone Number	:	212-241-6500
Fax Number	:

Authorized Official
Title or Position	:	CEO OF MEDICAL CENTER
Name	:	DON SCANLON
Credential	:
Telephone Number	:	212-731-3752

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	07/21/2022

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