Provider Demographics
NPI: | 1265870190 |
---|---|
Name: | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI |
Entity type: | Organization |
Organization Name: | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR IBD CENTER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | JEAN-FREDERIC |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | COLOMBEL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 212-659-9697 |
Mailing Address - Street 1: | BOX 1069 |
Mailing Address - Street 2: | ONE GUSTAVE L. LEVY PLACE |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10029-6574 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | ONE GUSTAVE L. LEVY PLACE |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10029-6574 |
Practice Address - Country: | US |
Practice Address - Phone: | 212-241-4299 |
Practice Address - Fax: | 212-849-2574 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-06-13 |
Last Update Date: | 2013-06-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 270631 | 284300000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 284300000X | Hospitals | Special Hospital |