# 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:** 1811127194
- **Authorized official:** MARLON E. BREWER MD (DIRECTOR)
- **Authorized official phone:** (718) 334-2490

## Contact information

- **Practice address:** 7901 BROADWAY, ROOM A1-9, ELMHURST, NY 11373-1329
- **Practice address phone:** (718) 334-4952
- **Practice address fax:** (718) 334-4815
- **Mailing address:** 7901 BROADWAY, ROOM A1-9, ELMHURST, NY 11373-1329
- **Mailing address phone:** (718) 334-4952
- **Mailing address fax:** (718) 334-4815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2009
- **Last updated:** 07/21/2009