Icahn School of Medicine at Mount Sinai

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Practice address

485 Merrick Rd
Rockville Centre, NY 11570-5436

Phone

(516) 255-9555

NPI assigned

Jun 3, 2020

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 1

Addresses

Other names 1

• MOUNT SINAI SN HOSPITAL PHYSICIANS-RAD ONC Other name

Tax ID family

Icahn School of Medicine at Mount Sinai5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Icahn School of Medicine at Mount Sinai

  • Diagnostic Radiology Physician
  • Rockville Centre, NY
  • NPI 1144844317
  NPD tax ID
• Icahn School of Medicine at Mount Sinai

  • Physiological Laboratory
  • Rockville Centre, NY
  • NPI 1407470453
  NPD tax ID
• Icahn School of Medicine at Mount Sinai

  • Diagnostic Radiology Physician
  • Oceanside, NY
  • NPI 1477177400
  NPD tax ID
• Icahn School of Medicine at Mount Sinai

  • Diagnostic Radiology Physician
  • Oceanside, NY
  • NPI 1811511702
  NPD tax ID

Locations

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1902420144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 EAST 42ND STREET",
            "address_2": "5TH FLOOR, 5.A.30.6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10017",
            "telephone_number": "646-605-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 MERRICK RD",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705436",
            "telephone_number": "516-255-9555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "516-632-4656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Rockville Centre",
            "state": "NY",
            "postal_code": "115705775",
            "country_code": "US",
            "telephone_number": "516-632-4656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 N Park Ave",
            "address_purpose": "LOCATION",
            "city": "Rockville Centre",
            "state": "NY",
            "postal_code": "115704113",
            "country_code": "US",
            "telephone_number": "516-255-9555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "185 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721431",
            "country_code": "US",
            "telephone_number": "516-766-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "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": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNT SINAI SN HOSPITAL PHYSICIANS-RAD ONC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Iadevaio, PA-C
• Robert Iadevaio, MD
• Gaetana Enza Iannelli, OD
• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Ihor Magun MD
• David D. Ilson, LCSW
• Yusef Imani, MD
• Imolloy College Rebecca Center
• Indra D. Daniels Physician PLLC

• Radiation Oncology Physician in Rockville Centre, NY
• Providers in Rockville Centre, NY by specialty
• Radiation Oncology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.