ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI (NPI# 1477926384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477926384 |
| Entity Type | Organization |
| Organization Name | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI |
| Other Organization Name | MOUNT SINAI DOCTORS CCSI |
| Practice Address |
11 Ralph Pl Suite 109 Staten Island NY 10304-4401 |
| Practice Telephone | 7189813674 |
| Mailing Telephone | 7189813674 |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2015-11-02 |
| Authorized Official Name | ALICIA GRESHAM (VP OF NETWORK OPERATIONS) |
| Authorized Official Telephone | 2126599038 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOUNT SINAI HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MOUNT SINAI DOCTORS CCSI | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144844317 | Icahn School of Medicine At Mount Sinai | Physiological Laboratory | 485 Merrick Rd, Rockville Centre, NY 11570-5436 | 2020-06-03 |
| 1013489426 | Icahn School of Medicine At Mount Sinai | Internal Medicine | 11 Madison Ave # Level1b, New York, NY 10010-3643 | 2018-12-24 |
| 1013498419 | Icahn School of Medicine At Mount Sinai | Family Medicine | 1203 Avenue J Fl 2, Brooklyn, NY 11230-3669 | 2018-08-23 |
| 1912499401 | Icahn School of Medicine At Mount Sinai | Registered Nurse | 2209 Merrick Rd Ste 101, Merrick, NY 11566 | 2018-05-31 |
| 1912376633 | Icahn School of Medicine At Mount Sinai | Pathology | 16 Street At 1st Avenue, New York, NY 10003 | 2015-09-23 |
| 1437525037 | Icahn School of Medicine At Mount Sinai | Obstetrics & Gynecology | 234 E. 85th St, 3rd Floor, New York, NY 10028 | 2015-08-18 |
| 1568841930 | Icahn School of Medicine At Mount Sinai | Dermatology | 222 West 14th Street, New York, NY 10011 | 2015-05-19 |
| 1568868834 | Icahn School of Medicine At Mount Sinai | Allergy & Immunology | 55 West 34th Street, 1st Floor, New York, NY 10016 | 2014-11-13 |
| 1427493113 | Icahn School of Medicine At Mount Sinai | Clinic/Center | 1468 Madison Ave Fl 3, New York, NY 10029-6508 | 2013-05-08 |
| 1558627844 | Icahn School of Medicine At Mount Sinai | Neurological Surgery | 5 East 98 Street 7th Floor, Newyork, NY 10029-6511 | 2012-04-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI | One Gustave L Levy Pl, New York, NY 10029-6504 |
| Connecticut Business Registrations | Icahn School of Medicine At Mount Sinai Inc. | One Gustave L. Levy Place, New York, NY 10029 |
| Street Address |
11 RALPH PL SUITE 109 |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10304-4401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154320638 | Hsien Kwang Liu | Specialist | 11 Ralph Pl, Suite 302, Staten Island, NY 10304-4419 | 2005-07-18 |
| 1265990097 | Natalia Maximovsky | Nurse Practitioner | 11 Ralph Pl, Staten Island, NY 10304-4401 | 2019-03-11 |
| 1376095992 | Ralph Place Optical LLC | Ophthalmology | 11 Ralph Pl, Suite 101, Staten Island, NY 10304-4401 | 2016-10-31 |
| 1376964452 | Juliana Tacardon | Registered Nurse | 11 Ralph Pl, Staten Island, NY 10304-4401 | 2013-12-17 |
| 1487990941 | Renata Zink | Nurse Practitioner | 11 Ralph Pl, Suite 214, Staten Island, NY 10304-4401 | 2013-01-02 |
| 1275818668 | Sima Raguthu Md Pllc | Psychiatry & Neurology | 11 Ralph Pl, Staten Island, NY 10304-4401 | 2011-10-17 |
| 1568746014 | Luis G. Miranda, M.d., P.C. | Urology | 11 Ralph Pl, Suite 202, Staten Island, NY 10304-4401 | 2011-10-03 |
| 1396025920 | R Reddi Muttana Md PC | Ophthalmology | 11 Ralph Pl, Suite 317a, Staten Island, NY 10304-4401 | 2011-08-26 |
| 1720366453 | Advanced Allergy & Asthma Family Care Pllc | Allergy & Immunology | 11 Ralph Pl, Suite 305, Staten Island, NY 10304-4401 | 2011-07-29 |
| 1205127669 | Targee Street Internal Medicine Group | Family Medicine | 11 Ralph Pl, Suite 317b, Staten Island, NY 10304-4401 | 2011-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215542923 | Margaret Chifong Tam | Nurse Practitioner | 85 Venice Avenue, Staten Island, NY 10304 | 2020-09-10 |
| 1598397788 | Alexandria & Akea's Playhouse, Inc. | Day Training, Developmentally Disabled Services | 1864 Clove Road, Staten Island, NY 10304 | 2020-02-06 |
| 1548746811 | Bryant Edward Pearson | Technician/Technologist | 664 Bay Street, Staten Island, NY 10304 | 2018-07-19 |
| 1366941668 | Safwat Attia Youssef | Orthopaedic Surgery | 25 Sunrise Terrace, Staten Island, New York, NY 10304 | 2018-02-02 |
| 1699294090 | Kate Lynn Chimienti | Specialist/Technologist | 52 Smith Ter Fl1, Staten Island, NY 10304 | 2017-09-17 |
| 1881117315 | Fun Speech Therapy, P.C. | Early Intervention Provider Agency | 367 St Pauls Ave., Staten Island, NY 10304 | 2017-07-17 |
| 1720517097 | Senada Pelinkovic | Speech-Language Pathologist | 29 Remsen St, Staten Island, NY 10304 | 2017-06-08 |
| 1760927255 | Kpannah Moore | Licensed Practical Nurse | 492 Vanderbilt Avenue, Staten Island, NY 10304 | 2016-12-20 |
| 1689116592 | Rena Li | Registered Nurse | 30 Celebration Lane, Staten Island, NY 10304 | 2016-11-09 |
| 1407304835 | Esther Mitnick | Counselor | 285 Vanderbilt Avenue, State Island, NY 10304 | 2016-09-14 |
| Find all providers in zip 10304 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982261145 | Magnim Kissao | Internal Medicine | 60 Hamilton Ave Apt 2e, Staten Island, NY 10301-1843 | 2019-05-23 |
| 1427595099 | Hari Gnanasekeram, PC | Internal Medicine | 405 Armstrong Ave, Staten Island, NY 10308-2629 | 2017-01-20 |
| 1073859203 | Ny Cardio Care Pllc | Internal Medicine | 1112 South Ave Ste A, Staten Island, NY 10314-3410 | 2012-12-16 |
| 1275832677 | Shivani Verma | Internal Medicine | 1332 Rockland Ave, Staten Island, NY 10314-4928 | 2011-03-24 |
| 1902127814 | Francesco Rotatori | Internal Medicine | 1058 Forest Ave, Staten Island, NY 10310-2419 | 2010-06-15 |
| 1366624744 | Mumtaz Jafri | Internal Medicine | 1366 Victory Blvd Ste B, Staten Island, NY 10301-3907 | 2007-11-28 |
| 1508927013 | Antonio Caracta | Internal Medicine | 491 Bard Ave, Staten Island, NY 10310-2103 | 2006-12-12 |
| 1417031949 | Abdul Wadood Ansari | Internal Medicine | 74 Ocean Ter, Staten Island, NY 10314-5650 | 2006-10-24 |
| 1114972718 | Andrew C Przybyla | Internal Medicine | 5 Crafton Ave, Staten Island, NY 10314 | 2006-05-23 |
| 1760457113 | Ayman E. Farid | Internal Medicine | 5091 Amboy Road, Staten Island, NY 10312 | 2006-02-21 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10304 |
Please comment or provide details below to improve the information on ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.