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Organization
NORTH SHORE MEDICAL GROUP OF THE MOUNT SINAI SCHOOL OF MEDICINE
Active
Organization
NORTH SHORE MEDICAL GROUP OF THE MOUNT SINAI SCHOOL OF MEDICINE
Active
Parent organization
MOUNT SINAI MEDICAL CENTER
Other names
North Shore Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOUNT SINAI MEDICAL CENTER
Authorized official
MS. ALICIA GRESHAM (VP NETWORK OPERATIONS)
(212) 659-9038
Entity
Organization
Contact information
Practice address
1436 BROADWAY, HEWLETT, NY 11557-1405
(929) 210-6570
(929) 210-6571
Mailing address
1436 BROADWAY, HEWLETT, NY 11557-1405
(929) 210-6570
(929) 210-6571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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