Icahn School of Medicine at Mount Sinai

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Practice address

2965 Long Beach Rd
Oceanside, NY 11572-3255

Phone

(516) 593-8953

NPI assigned

Jul 23, 2018

Organization subpart

No

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 1

Addresses

Other names 1

• MOUNT SINAI DOCTORS SOUTH NASSAU - GASTROENTEROLOGY Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1326525320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723255",
            "telephone_number": "516-593-8953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "516-593-8953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "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": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNT SINAI DOCTORS SOUTH NASSAU - GASTROENTEROLOGY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MOUNT SINAI DOCTORS SOUTH NASSAU - GASTROENTEROLOGY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Hwang, NP
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• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai

• Gastroenterology Physician in Oceanside, NY
• Providers in Oceanside, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.