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Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Other names
ENT Dentistry Department of Mount Sinai
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRYSTAL MACNEILL (VICE PRESIDENT, CBO DIRECTOR)
(646) 605-8112
Entity
Organization
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6504
(212) 241-9410
Mailing address
150 E 42ND ST, 10TH FLOOR, NEW YORK, NY 10017-5612
(646) 605-8119
(646) 605-3031
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
NULL
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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