Icahn School of Medicine at Mount Sinai

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Practice address

1910 Richmond Rd
Staten Island, NY 10306-2552

Phone

(718) 987-9777

NPI assigned

Jun 12, 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 Network Operations

Phone

(212) 659-9038

Specialties & licenses 3

Addresses

Other names 2

• MOUNT SINAI DOCTORS SI CANCER Doing business as
• Mount Sinai Doctors SI Caner Doing business as

Locations

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1740773936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062552",
            "telephone_number": "718-987-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062552",
            "telephone_number": "718-987-9777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "883 Poole Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Hazlet",
            "state": "NJ",
            "postal_code": "077302040",
            "country_code": "US",
            "telephone_number": "732-203-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-12",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "VP NETWORK OPERATIONS",
        "authorized_official_telephone_number": "212-659-9038"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNT SINAI DOCTORS SI CANCER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mount Sinai Doctors SI Caner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Idan Sharon, MD, PC

• Hematology & Oncology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Hematology & Oncology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.