Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Other names
MT SINAI DOCTORS BK MULTISPECIALTY
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA GRESHAM (VP NETWORK OPERATIONS)
(212) 659-9038
Entity
Organization
Contact information
Practice address
1203 AVENUE J FL 2, BROOKLYN, NY 11230-3669
(718) 252-5800
Mailing address
1203 AVENUE J FL 2, BROOKLYN, NY 11230-3669
(718) 252-5800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
08/23/2018
Last updated
01/17/2020
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