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Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Parent organization
MOUNT SINAI HOSPITAL
Other names
MT SINAI DOCTORS STATEN ISLAND GI
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOUNT SINAI HOSPITAL
Authorized official
ALICIA GRESHAM (VP OF NETWORK OPERATIONS)
(212) 659-9038
Entity
Organization
Contact information
Practice address
129 SLOSSON AVE, STATEN ISLAND, NY 10314-2522
(718) 720-5928
(718) 720-6706
Mailing address
129 SLOSSON AVE, STATEN ISLAND, NY 10314-2522
(718) 720-5928
(718) 720-6706
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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