Provider Demographics
NPI:1437172335
Name:MOUNT SINAI SCHOOL OF MEDICINE
Entity Type:Organization
Organization Name:MOUNT SINAI SCHOOL OF MEDICINE
Other - Org Name:MSHQ-ANESTHESIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
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:212-241-6752
Mailing Address - Street 1:PO BOX 12023
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-5023
Mailing Address - Country:US
Mailing Address - Phone:800-627-4470
Mailing Address - Fax:412-937-5710
Practice Address - Street 1:2510 30TH AVE
Practice Address - Street 2:ANESTHESIOLOGY
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2448
Practice Address - Country:US
Practice Address - Phone:800-627-4470
Practice Address - Fax:412-937-5710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY08013Medicare PIN