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Organization
MOUNT SINAI SCHOOL OF MEDICINE
Active
Organization
MOUNT SINAI SCHOOL OF MEDICINE
Active
Other names
Mount Sinai Marathon Medical - Int Med / Family Med
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA GRESHAM (VP NETWORK OPERATIONS)
(212) 659-9038
Entity
Organization
Contact information
Practice address
196 MERRICK RD, OCEANSIDE, NY 11572-1420
(516) 255-8400
Mailing address
196 MERRICK RD, OCEANSIDE, NY 11572-1420
(516) 255-8400
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RB0002X
Obesity Medicine (Internal Medicine) Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/26/2018
Last updated
01/11/2019
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