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Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Other names
MOUNT SINAI DOCTORS SOUTH NASSAU - MFM
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA GRESHAM (VP OF NETWORK OPERATIONS)
(212) 659-9038
Entity
Organization
Contact information
Practice address
196 MERRICK RD, OCEANSIDE, NY 11572
(516) 255-8400
Mailing address
196 MERRICK RD, OCEANSIDE, NY 11572-1420
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
NULL
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Enumeration date
06/04/2018
Last updated
06/08/2018
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