Provider Demographics
NPI:1831342690
Name:MOUNT SINAI CARDIOTHORACIC SURGERY LLC
Entity type:Organization
Organization Name:MOUNT SINAI CARDIOTHORACIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUTKAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-674-1212
Mailing Address - Street 1:PO BOX 816759
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33081-0759
Mailing Address - Country:US
Mailing Address - Phone:305-674-1233
Mailing Address - Fax:954-964-6084
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:SUITE 2110
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2800
Practice Address - Country:US
Practice Address - Phone:305-674-2780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty