Provider Demographics
NPI:1740224559
Name:MOUNT SINAI SCHOOL OF MEDICINE
Entity Type:Organization
Organization Name:MOUNT SINAI SCHOOL OF MEDICINE
Other - Org Name:DEPT. OF HUMAN GENETICS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAKIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-731-3241
Mailing Address - Street 1:ONE GUSTAVE LEVY PLACE
Mailing Address - Street 2:BOX 1497
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ONE GUSTAVE LEVY PL.
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-731-3241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01366572Medicaid
NY01366572Medicaid