Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Other names
MOUNT SINAI DOCTORS SOUTH NASSAU-RADIOLOGY, RADIOLOGY AT MOUNT SINAI DOCTORS SOUTH NASSAU
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA GRESHAM (VP OF NETWORK OPERATIONS)
(212) 659-9038
Entity
Organization
Contact information
Practice address
185 MERRICK RD, OCEANSIDE, NY 11572-1431
(516) 766-6550
Mailing address
185 MERRICK RD, OCEANSIDE, NY 11572-1431
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Enumeration date
06/05/2018
Last updated
06/16/2018
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