Organization
MOUNT SINAI SCHOOL OF MEDICINE
Active
Parent organization
MOUNT SINAI SCHOOL OF MEDICINE
Other names
Offsite Robbins Cardiology
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOUNT SINAI SCHOOL OF MEDICINE
Authorized official
DOUGLAS A JABS M.D., M.B.A. (CHIEF EXECUTIVE OFFICER, FPA)
(212) 241-6752
Entity
Organization
Contact information
Practice address
9436 58TH AVE, SUITE G4, ELMHURST, NY 11373-5149
(718) 760-0011
(718) 760-0685
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
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G100027019
MEDICARE QUEENS COUNTY
NY
Enumeration date
06/15/2010
Last updated
02/15/2011
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