Active NPI
Icahn School of Medicine at Mount Sinai
Doing business as Mt Sinai Doctors Staten Island Gi
- Gastroenterology Physician
- Staten Island, NY
National Provider Identifier
1255882734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- Doing business as
- Mt Sinai Doctors Staten Island Gi
- Practice address
- 129 Slosson Ave
Staten Island, NY 10314-2522 - Phone
- (718) 720-5928
- Fax
- (718) 720-6706
- NPI assigned
- Oct 19, 2016
- Last updated
- Oct 19, 2016
- Organization subpart
- Yes
- Parent organization
- MOUNT SINAI HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alicia Gresham
- Title
- VP of Network Operations
- Phone
- (212) 659-9038
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | NU | ||
| Gastroenterology Physician | 207RG0100X | NU | Primary |
Addresses
Primary practice location
129 Slosson Ave
Staten Island, NY 10314-2522
Mailing address
129 Slosson Ave
Staten Island, NY 10314-2522
Phone (718) 720-5928
Other names 1
- MT SINAI DOCTORS STATEN ISLAND GI
National Provider Directory
National Provider Directory- Part of
- MSHQ Emergency Care Associates
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1476835200000",
"number": "1255882734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 SLOSSON AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103142522",
"telephone_number": "718-720-5928",
"fax_number": "718-720-6706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 SLOSSON AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103142522",
"telephone_number": "718-720-5928",
"fax_number": "718-720-6706"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MOUNT SINAI HOSPITAL",
"enumeration_date": "2016-10-19",
"last_updated": "2016-10-19",
"status": "A",
"authorized_official_last_name": "GRESHAM",
"authorized_official_first_name": "ALICIA",
"authorized_official_title_or_position": "VP OF NETWORK OPERATIONS",
"authorized_official_telephone_number": "212-659-9038"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MT SINAI DOCTORS STATEN ISLAND GI",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Staten Island, NY
- Rami Ibrahim, PT,DPT
- Sandy Ibrahim, PA
- Youssef Ibrahim
- Ibram Pharmacy Inc (Seaview Pharmacy)
- Ibram Pharmacy Inc (Seaview Pharmacy)
- Icahn School of Medicine at Mount Sinai (Mt Sinai Doctors Si-Victory Int Med)
- Icahn School of Medicine at Mount Sinai (Mt Sinai Doctors Staten Island Medicine)
- Icahn School of Medicine at Mount Sinai (Mount Sinai Doctors Ccsi)
- Icahn School of Medicine at Mount Sinai (Mount Sinai Doctors Si Cancer)
- Icahn School of Medicine at Mount Sinai (Mt Sinai Doctors Staten Island Medicine)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.