Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Other names
Mount Sinai Hospital Based Providers
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD A PETERSON (AUTHORIZED OFFICIAL)
(646) 605-8145
Entity
Organization
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6504
(212) 241-6500
Mailing address
150 E 42ND ST FL 2, NEW YORK, NY 10017-5612
(646) 605-8119
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
12/31/2012
Last updated
12/09/2022
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