# MOUNT SINAI SCHOOL OF MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mount Sinai Elmhurst Faculty Practice Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669602967
- **Authorized official:** DR. MARTIN FINE MD (DIRECTOR)
- **Authorized official phone:** (718) 334-2061

## Contact information

- **Practice address:** 7901 BROADWAY, ROOM A1-19, ELMHURST, NY 11373-1329
- **Practice address phone:** (718) 334-4952
- **Practice address fax:** (718) 334-4815
- **Mailing address:** 7901 BROADWAY, ROOM A1-19, ELMHURST, NY 11373-1329
- **Mailing address phone:** (718) 334-4952
- **Mailing address fax:** (718) 334-4815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | — |
| 2080P0201X | Pediatric Allergy/Immunology Physician | — | NULL | — |
| 2080P0201X | Pediatric Allergy/Immunology Physician | — | — | — |
| 2080P0202X | Pediatric Cardiology Physician | — | NULL | — |
| 2080P0202X | Pediatric Cardiology Physician | — | — | — |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | NULL | — |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | — | — |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | — | NULL | Yes |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | — | — | Yes |
| 2080P0205X | Pediatric Endocrinology Physician | — | NULL | — |
| 2080P0205X | Pediatric Endocrinology Physician | — | — | — |
| 2080P0206X | Pediatric Gastroenterology Physician | — | NULL | — |
| 2080P0206X | Pediatric Gastroenterology Physician | — | — | — |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | NULL | — |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | — | — |
| 2080P0208X | Pediatric Infectious Diseases Physician | — | NULL | — |
| 2080P0208X | Pediatric Infectious Diseases Physician | — | — | — |
| 2080P0210X | Pediatric Nephrology Physician | — | NULL | — |
| 2080P0210X | Pediatric Nephrology Physician | — | — | — |
| 2080P0214X | Pediatric Pulmonology Physician | — | NULL | — |
| 2080P0214X | Pediatric Pulmonology Physician | — | — | — |
| 2080P0216X | Pediatric Rheumatology Physician | — | NULL | — |
| 2080P0216X | Pediatric Rheumatology Physician | — | — | — |

## Other

- **Enumeration date:** 07/21/2009
- **Last updated:** 08/12/2013