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Organization

ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Active
Other names
ENT Dentistry Department of Mount Sinai
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
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6504
(212) 241-9410
Mailing address
150 E 42ND ST, 10TH FLOOR, NEW YORK, NY 10017-5612
(646) 605-8119
(646) 605-3031

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
1223P0106X
Oral and Maxillofacial Pathology Dentistry
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
03/08/2016
Last updated
03/08/2016
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