# MOUNT SINAI SCHOOL OF MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MOUNT SINAI MARATHON MEDICAL -NEONATES/PEDIATRICS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396212445
- **Authorized official:** ALICIA GRESHAM (VP NETWORK OPERATIONS)
- **Authorized official phone:** (212) 659-9038

## Contact information

- **Practice address:** 8 N OCEANSIDE RD, ROCKVILLE CENTRE, NY 11570-5125
- **Practice address phone:** (516) 632-3670
- **Mailing address:** 8 N OCEANSIDE RD, ROCKVILLE CENTRE, NY 11570-5125
- **Mailing address phone:** (516) 632-3670

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | Yes |
| 2080P0202X | Pediatric Cardiology Physician | — | NULL | — |
| 2080P0202X | Pediatric Cardiology Physician | — | — | — |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |

## Other

- **Enumeration date:** 10/26/2018
- **Last updated:** 01/11/2019