# ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PHYSICAL MED & REHAB AT MOUNT SINAI DOCTORS SOUTH NASSAU, MOUNT SINAI DOCTORS SOUTH NASSAU - PHYSICAL MED & REHAB
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598257644
- **Authorized official:** ALICIA GRESHAM (VP OF NETWORK OPERATIONS)
- **Authorized official phone:** (212) 659-9038

## Contact information

- **Practice address:** 440 MERRICK RD, OCEANSIDE, NY 11572-1404
- **Practice address phone:** (516) 255-8200
- **Mailing address:** 440 MERRICK RD, OCEANSIDE, NY 11572-1404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2018
- **Last updated:** 06/16/2018