Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Other names
FPA Out of Network
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
ONE GUSTAVE L. LEVY PLACE, NEW YORK, NY 10029
(646) 605-8119
(646) 605-3029
Mailing address
150 EAST 42ND STREET, NEW YORK, NY 10017
(646) 605-8119
(646) 605-3029
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
04/24/2015
Last updated
04/24/2015
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