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General NPI Number Information
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NPI Number | 1508333956
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Entity Type | Organization
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Legal Business Name | MOUNT SINAI SCHOOL OF MEDICINE
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Dates
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Enumeration Date | 10/24/2018
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Last Update Date | 01/11/2019
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Provider Practice Location Address
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Address Line | 175 FULTON AVE STE 309
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City | HEMPSTEAD
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State | NY
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Zip | 11550-3702
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Country | US
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Telephone | 516-485-5710
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Fax | 516-485-4225
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Provider Business Mailing Address
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Address Line | 1 HEALTHY WAY
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City | OCEANSIDE
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State | NY
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Zip | 11572-1551
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP NETWORK OPERATIONS
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Name | ALICIA GRESHAM
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Credential |
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Telephone | 212-659-9038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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