a Mount Faculty Practice Sinai Doctors CARDIOVASCULAR INSTITUTE OF MO P.O. BOX 28083 NEW YORK NY 10087-8083 FOR BILLING INQUIRIES: "P dfill09HOIN90"0"1410"09P41440I J

M error, please notify the sender immediately by phone. EFTA00283626 07/25/2014 04:16am DISH 1010..•••••••••••••,...^T WTI?" gl40 rage ULFVV Mount Faculty Practice Sinai Doctors CONSENT FOR COMMUNICATION VIA E-MAIL (Provider-Patient) , hereby consent to have my physician, . , communicate with me or member

Mount Faculty Practice Sinai Doctors Rony Shimony, MD 485 Madison Ave 17th Floor New York, NY 10022 Radiology Associates 1176 Fifth Avenue. MC Level 1470 Mao son Av

-120 1 120+ 0.00 0.00 I 0.00 Receive Email Statements Register Today! O a tn. 6..o. 4, t. VISIT: EFTA00317365 fik PHYSICIAN SERVICES Mount Faculty Practice Sinai Doctors YOU CAN PAY YOUR BILL ONLINE TODAY! SEE PAYMENT OPTIONS Service Loc. ACCOUNT NUMBER Description OFFICE VISiT - LE E 3 TOTA