Basic Information
Provider Information
NPI: 1164682340
EntityType: 2
ReplacementNPI:  
OrganizationName: MOUNT SINAI HOSPITAL
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: 1 GUSTAVE L LEVY PL
Address2:  
City: NEW YORK
State: NY
PostalCode: 100296500
CountryCode: US
TelephoneNumber: 2122416500
FaxNumber:  
Practice Location
Address1: 1 GUSTAVE L LEVY PL
Address2:  
City: NEW YORK
State: NY
PostalCode: 100296500
CountryCode: US
TelephoneNumber: 2122416500
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/11/2008
LastUpdateDate: 06/11/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ZAMARIN
AuthorizedOfficialFirstName: DMITRIY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: HOUSE STAFF
AuthorizedOfficialTelephone: 9176920956
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD PHD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X  Y HospitalsGeneral Acute Care Hospital 

No ID Information.


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