Organization · Type 2 NPI

Icahn School of Medicine at Mount Sinai

Hematology & Oncology Physician · Staten Island, NY

NPI number 1740773936 Active

Practice location

1910 Richmond Rd
Staten Island, NY 10306-2552

Call (718) 987-9777 Map

Other practice locations

883 Poole Ave Ste 4, Hazlet, NJ 07730-2040 · (732) 203-9500

Specialties and licenses

Taxonomy	Code	License
Hematology (Internal Medicine) Physician	207RH0000X	None listed
Hematology & Oncology Physician Primary	207RH0003X	None listed
Medical Oncology Physician	207RX0202X	None listed

Hematology & Oncology Physician: An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

2 other providers at this address

Other hematology & oncology physician providers in Staten Island

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NPI record

NPI: 1740773936
Entity type: Organization (Type 2)
Issued: Jun 12, 2018
Last updated: Jan 17, 2020
Status: Active

Other names

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Mount Sinai Doctors Si Cancer · doing business as
Mount Sinai Doctors Si Caner · doing business as

Authorized official

Alicia Gresham
VP Network Operations
(212) 659-9038

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1740773936

Icahn School of Medicine at Mount Sinai's National Provider Identifier is 1740773936, issued on Jun 12, 2018. The primary taxonomy on file is Hematology & Oncology Physician (207RH0003X), and the practice location is in Staten Island, NY. The record was last updated on Jan 17, 2020.