# ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MOUNT SINAI DOCTORS SOUTH NASSAU - HEMATOLOGY / ONCOLOGY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912499401
- **Authorized official:** ALICIA GRESHAM (VP OF NETWORK OPERATIONS)
- **Authorized official phone:** (212) 659-9038

## Contact information

- **Practice address:** 2209 MERRICK RD STE 101, MERRICK, NY 11566
- **Practice address phone:** (516) 546-5000
- **Mailing address:** 1 HEALTHY WAY, OCEANSIDE, NY 11572-1551

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WM0705X | Medical-Surgical Registered Nurse | — | NULL | — |
| 163WM0705X | Medical-Surgical Registered Nurse | — | — | — |
| 163WX0200X | Oncology Registered Nurse | — | NULL | — |
| 163WX0200X | Oncology Registered Nurse | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |
| 2085R0001X | Radiation Oncology Physician | — | NULL | — |
| 2085R0001X | Radiation Oncology Physician | — | — | — |

## Other

- **Enumeration date:** 05/31/2018
- **Last updated:** 06/08/2018