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Organization

ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRYSTAL MACNEILL (V.P.,CBO DIRECTOR FPA BILLING)
(212) 731-6802
Entity
Organization

Contact information

Practice address
1468 MADISON AVE, ANNENBERG BLD 2ND FLOOR, NEW YORK, NY 10029-6508
(212) 241-2375
Mailing address
150 E 42ND ST FL 10, NEW YORK, NY 10017-5626
(646) 605-8119

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
04/11/2013
Last updated
10/09/2017
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