Icahn School of Medicine at Mount Sinai

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

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 1, 2018

Last updated

Jun 16, 2018By the provider in NPPES

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 9

Addresses

Other names 2

• MOUNT SINAI DOCTORS SOUTH NASSAU - INTERNAL /FAMILY MEDICINE Other name
• MOUNT SINAI DOCTORS SOUTH NASSAU - INTERNAL/FAMILY MEDICINE Other name

Locations

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1942792304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551"
        },
        {
            "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": [
        {
            "address_1": "1 S Central Ave",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115805443",
            "country_code": "US",
            "telephone_number": "516-763-7820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "761 Franklin Blvd",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "NY",
            "postal_code": "115612450",
            "country_code": "US",
            "telephone_number": "516-544-2351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 W Park Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "NY",
            "postal_code": "115613223",
            "country_code": "US",
            "telephone_number": "516-432-4154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2750 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Bellmore",
            "state": "NY",
            "postal_code": "117105720",
            "country_code": "US",
            "telephone_number": "516-409-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Fulton Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Hempstead",
            "state": "NY",
            "postal_code": "115503917",
            "country_code": "US",
            "telephone_number": "877-768-8462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1436 Broadway",
            "address_purpose": "LOCATION",
            "city": "Hewlett",
            "state": "NY",
            "postal_code": "115571405",
            "country_code": "US",
            "telephone_number": "516-497-7422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 Broadway",
            "address_purpose": "LOCATION",
            "city": "Hewlett",
            "state": "NY",
            "postal_code": "115571321",
            "country_code": "US",
            "telephone_number": "516-374-8631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2280 Grand Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Baldwin",
            "state": "NY",
            "postal_code": "115103110",
            "country_code": "US",
            "telephone_number": "516-623-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "185 Merrick Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Lynbrook",
            "state": "NY",
            "postal_code": "115632700",
            "country_code": "US",
            "telephone_number": "516-887-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2750 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Bellmore",
            "state": "NY",
            "postal_code": "117105720",
            "country_code": "US",
            "telephone_number": "516-409-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 W Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "NY",
            "postal_code": "115203743",
            "country_code": "US",
            "telephone_number": "516-379-3139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2965 Long Beach Rd",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115723255",
            "country_code": "US",
            "telephone_number": "516-593-8953",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "877-768-8462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-06-16",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNT SINAI DOCTORS SOUTH NASSAU - INTERNAL /FAMILY MEDICINE",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MOUNT SINAI DOCTORS SOUTH NASSAU - INTERNAL/FAMILY MEDICINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• 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
• Justin Im
• Afm Ashik Imran, DO
• Infused Health and Wellness
• Insured Medical Supply Inc.

• Internal Medicine Physician in Oceanside, NY
• Providers in Oceanside, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.