Provider Demographics
NPI:1134585953
Name:MOUNT SINAI BETH ISRAEL
Entity type:Organization
Organization Name:MOUNT SINAI BETH ISRAEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUM-WOO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:212-420-3969
Mailing Address - Street 1:10 NATHAN D PERLMAN PLACE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-420-3969
Mailing Address - Fax:212-420-4575
Practice Address - Street 1:10 NATHAN D PERLMAN PL
Practice Address - Street 2:3S21B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3851
Practice Address - Country:US
Practice Address - Phone:212-420-3969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041299282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY041299OtherNYS LICENSE NUMBER