Organization
MOUNT SINAI SCHOOL OF MEDICINE
Active
Other names
Offsite DiStefano Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS A JABS M.D. , M.B.A. (CHIEF EXECUTIVE OFFICER)
(212) 241-6752
Entity
Organization
Contact information
Practice address
1185 PARK AVE, NEW YORK, NY 10128-1308
(212) 427-6101
Mailing address
1 GUSTAVE L LEVY PL, BOX 1621, NEW YORK, NY 10029-6500
(212) 731-7895
(212) 348-6158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
—
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
08/24/2010
Last updated
02/15/2011
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