Provider Demographics
NPI: | 1477177400 |
---|---|
Name: | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI |
Entity Type: | Organization |
Organization Name: | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI |
Other - Org Name: | MOUNT SINAI SN HOSPITAL PHYSICIANS |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | FINANCE MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | PUNITA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | DARJI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 646-634-9814 |
Mailing Address - Street 1: | 1 HEALTHY WAY |
Mailing Address - Street 2: | |
Mailing Address - City: | OCEANSIDE |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11572-1551 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 516-632-4656 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 185 MERRICK RD |
Practice Address - Street 2: | |
Practice Address - City: | OCEANSIDE |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11572-1431 |
Practice Address - Country: | US |
Practice Address - Phone: | 516-766-6550 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-06-05 |
Last Update Date: | 2022-06-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Single Specialty |