Organization
MOUNT SINAI SCHOOL OF MEDICINE
Active
Other names
Mount Sinai Marathon Medical - Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA GRESHAM (VP NETWORK OPERATIONS)
(212) 659-9038
Entity
Organization
Contact information
Practice address
175 FULTON AVE STE 309, HEMPSTEAD, NY 11550-3702
(516) 485-5710
(516) 485-4225
Mailing address
1 HEALTHY WAY, OCEANSIDE, NY 11572-1551
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/24/2018
Last updated
01/11/2019
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