MEDICARE: MOUNT SINAI HOSPITAL

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

General Provider Information

NPI Number	:	1710912423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNT SINAI HOSPITAL

Provider Business Mailing Address
First Line	:	2715 30TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11102-2445
Country	:	US
Telephone Number	:	718-267-4808
Fax Number	:

Provider Business Practice Location Address
First Line	:	2715 30TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11102-2445
Country	:	US
Telephone Number	:	718-267-4808
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	RITA KLARIS
Credential	:
Telephone Number	:	718-267-4245

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	08/22/2020

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