MEDICARE: MOUNT SINAI SCHOOL OF MEDICINE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician
3	207RC0001X	Clinical Cardiac Electrophysiology Physician
4	207RI0011X	Interventional Cardiology Physician
5	207UN0901X	Nuclear Cardiology Physician
6	2080P0202X	Pediatric Cardiology Physician
7	208600000X	Surgery Physician
8	208D00000X	General Practice Physician
9	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1912213364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNT SINAI SCHOOL OF MEDICINE

Provider Business Mailing Address
First Line	:	1 GUSTAVE L LEVY PL
Second Line	:	BOX 1621
City	:	NEW YORK
State	:	NY
Zip	:	10029-6500
Country	:	US
Telephone Number	:	212-731-7895
Fax Number	:	212-348-6158

Provider Business Practice Location Address
First Line	:	1185 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-1308
Country	:	US
Telephone Number	:	212-427-6101
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. DOUGLAS A JABS
Credential	:	M.D. , M.B.A.
Telephone Number	:	212-241-6752

Provider Enumeration Date	:	08/24/2010
Last Update Date	:	02/15/2011

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Directions to “MOUNT SINAI SCHOOL OF MEDICINE ” Practice Location

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