Provider Demographics
NPI:1164714432
Name:MOUNT SINAI SCHOOL OF MEDICINE
Entity Type:Organization
Organization Name:MOUNT SINAI SCHOOL OF MEDICINE
Other - Org Name:CERTIFIED DIABETES EDUCATOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:JABS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:212-241-6762
Mailing Address - Street 1:1 GUSTAVE L LEVY PLACE
Mailing Address - Street 2:BOX 1068
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-6071
Mailing Address - Fax:212-241-7959
Practice Address - Street 1:1 GUSTAVE L LEVY PLACE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-6071
Practice Address - Fax:212-241-7959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty