Provider Demographics
NPI:1124081815
Name:CMORS GROUP LLC
Entity type:Organization
Organization Name:CMORS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSALATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-367-8800
Mailing Address - Street 1:3235 GRAND CONCOURSE
Mailing Address - Street 2:SUITE-BASEMENT
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-1138
Mailing Address - Country:US
Mailing Address - Phone:718-367-8800
Mailing Address - Fax:718-367-4047
Practice Address - Street 1:3235 GRAND CONCOURSE
Practice Address - Street 2:SUITE-BASEMENT
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-1138
Practice Address - Country:US
Practice Address - Phone:718-367-8800
Practice Address - Fax:718-367-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210513207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY028117OtherLICENSE NUMBER
NY210513OtherLICENSE NUMBER
NY021579OtherLICENSE #