Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Other names
SURGERY AT MOUNT SINAI DOCTORS SOUTH NASSAU, MOUNT SINAI DOCTORS SOUTH NASSAU-SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA GRESHAM (VP OF NETWORK OPERATIONS)
(212) 659-9038
Entity
Organization
Contact information
Practice address
1 HEALTHY WAY, OCEANSIDE, NY 11572-1551
(516) 632-3350
Mailing address
1 HEALTHY WAY, OCEANSIDE, NY 11572-1551
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
Primary
—
—
2086S0102X
Surgical Critical Care Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
208800000X
Urology Physician
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/07/2018
Last updated
06/16/2018
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