NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

  • Maternal & Fetal Medicine Physician
  • Oceanside, NY
National Provider Identifier
1720570922
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Practice address
196 Merrick Rd
Oceanside, NY 11572
Phone
(516) 255-8400
NPI assigned
Jun 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VM0101X Primary

Addresses

Primary practice location

196 Merrick Rd
Oceanside, NY 11572

Mailing address

196 Merrick Rd
Oceanside, NY 11572-1420

Other names 1

  • MOUNT SINAI DOCTORS SOUTH NASSAU - MFM Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528416000000",
    "number": "1720570922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 MERRICK RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 MERRICK RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "11572",
            "telephone_number": "516-255-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-08",
        "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": "207VM0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNT SINAI DOCTORS SOUTH NASSAU - MFM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.