Provider Demographics
NPI:1790012599
Name:MOUNT SINAI DEPARTMENT OF ORTHOPAEDIC SURGERY
Entity Type:Organization
Organization Name:MOUNT SINAI DEPARTMENT OF ORTHOPAEDIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:JABS
Authorized Official - Suffix:
Authorized Official - Credentials:MD MBA
Authorized Official - Phone:212-241-9203
Mailing Address - Street 1:5 E 98TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6501
Mailing Address - Country:US
Mailing Address - Phone:212-241-6980
Mailing Address - Fax:
Practice Address - Street 1:2800 MARCUS AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1008
Practice Address - Country:US
Practice Address - Phone:516-622-6040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty