# MOUNT SINAI SCHOOL OF MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MOUNT SINAI MARATHON MEDICAL - IDTF
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720636483
- **Authorized official:** ALICIA GRESHAM (VP NETWORK OPERATIONS)
- **Authorized official phone:** (212) 659-9038

## Contact information

- **Practice address:** 185 MERRICK RD, OCEANSIDE, NY 11572-1431
- **Practice address phone:** (516) 766-6550
- **Mailing address:** 185 MERRICK RD, OCEANSIDE, NY 11572-1431
- **Mailing address phone:** (516) 766-6550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | NULL | Yes |

## Other

- **Enumeration date:** 08/27/2019
- **Last updated:** 08/27/2019