Provider Demographics
NPI:1306867650
Name:MOUNT SINAI SCHOOL OF MEDICINE
Entity Type:Organization
Organization Name:MOUNT SINAI SCHOOL OF MEDICINE
Other - Org Name:MOUNT SINAI NUCLEAR MEDICINE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-241-6381
Mailing Address - Street 1:ONE GUSTAVE LEVY L. PLACE
Mailing Address - Street 2:1141
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-8426
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE L. LEVY PLACE
Practice Address - Street 2:1141
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-8426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNT SINAI SCHOOL OF MEDICINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-22
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00683321Medicaid
NY00683321Medicaid