Basic Information
| Provider Information | |||||||||
| NPI: | 1396165437 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOUNT SINAI HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 39 ARBOR CREEK DR | ||||||||
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| City: | PITTSFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145349530 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | ONE GUSTAVE L. LEVY PLACE | ||||||||
| Address2: | BOX 1139 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100296574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122416500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2014 | ||||||||
| LastUpdateDate: | 04/16/2014 | ||||||||
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| AuthorizedOfficialLastName: | GARNEAU | ||||||||
| AuthorizedOfficialFirstName: | JONATHAN | ||||||||
| AuthorizedOfficialMiddleName: | CONSTANTINE | ||||||||
| AuthorizedOfficialTitleorPosition: | OTOLARYNGOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 5855860988 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.