Organization
MOUNT SINAI QUEENS FACULTY PRACTICE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISE MARY REHWALDT M.D. (DIRECTOR.)
(718) 883-3000
Entity
Organization
Contact information
Practice address
8268 164TH ST, ROOM B265, JAMAICA, NY 11432-1121
(718) 883-3000
(718) 883-6129
Mailing address
8268 164TH ST, ROOM B265, JAMAICA, NY 11432-1121
(718) 883-3000
(718) 883-6129
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01415172
—
NY
Enumeration date
08/28/2006
Last updated
08/22/2020
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