Provider Demographics
NPI:1588723456
Name:MOUNT SINAI SCHOOL OF MEDICINE
Entity type:Organization
Organization Name:MOUNT SINAI SCHOOL OF MEDICINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAKIER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:212-241-3055
Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 1497
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-241-8717
Mailing Address - Fax:212-241-9467
Practice Address - Street 1:1184 5TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-241-0915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01366572Medicaid
NY01366572Medicaid