Organization
MOUNT SINAI SCHOOL OF MEDICINE
Active
Other names
Mount Sinai Marathon Medical - Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA GRESHAM (VP NETWORK OPERATIONS)
(212) 659-9038
Entity
Organization
Contact information
Practice address
2965 LONG BEACH RD, OCEANSIDE, NY 11572-3255
(516) 992-5626
Mailing address
2965 LONG BEACH RD, OCEANSIDE, NY 11572-3255
(516) 992-5626
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/26/2018
Last updated
01/11/2019
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