Provider Demographics
NPI:1245575927
Name:FACULTY PRACTICE ASSOCIATGE, MOUNT SINAI SCHOOL OF MEDICINE
Entity Type:Organization
Organization Name:FACULTY PRACTICE ASSOCIATGE, MOUNT SINAI SCHOOL OF MEDICINE
Other - Org Name:CARDIOTHORACIC SURGERY OF MOUNT SINAI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:P
Authorized Official - Last Name:WARKENTHIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-241-4546
Mailing Address - Street 1:1190 5TH AVE
Mailing Address - Street 2:BOX 1028
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6503
Mailing Address - Country:US
Mailing Address - Phone:212-241-5646
Mailing Address - Fax:212-241-0038
Practice Address - Street 1:1190 5TH AVE
Practice Address - Street 2:BOX 1028
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-241-5646
Practice Address - Fax:212-241-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty