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Organization

FPA OUT OF NETWORK

Active
Other names
Mount Sinai School of Medicine
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 10029-6574
(646) 605-8119
(646) 605-3029
Mailing address
PO BOX 28082, NEW YORK, NY 10087-8082
(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
208000000X
Pediatrics Physician
2084N0400X
Neurology Physician
208600000X
Surgery Physician

Other

Enumeration date
04/22/2015
Last updated
04/22/2015
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