Icahn School of Medicine at Mount Sinai

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Practice address

11 Ralph PL
Suite 109
Staten Island, NY 10304-4401

Phone

(718) 981-3674

NPI assigned

Nov 2, 2015

Organization subpart

Yes

Parent organization

MOUNT SINAI HOSPITALAs reported in NPPES

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 CCSI Doing business as

Part of

Mt Sinai Hospital of Qu

Locations

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1477926384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 RALPH PL",
            "address_2": "SUITE 109",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044401",
            "telephone_number": "718-981-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RALPH PL",
            "address_2": "SUITE 109",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044401",
            "telephone_number": "718-981-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNT SINAI HOSPITAL",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "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": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNT SINAI DOCTORS CCSI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ibram Pharmacy Inc
• Ibram Pharmacy Inc
• 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
• Inna Ichtchenko, BS IN PHARMACY
• Ichthysroe, LLC
• Ics Care

• Cardiovascular Disease Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.