| Mt Sinai Doctors Si-victory Int Med | |
|
2315 Victory Blvd Staten Island NY 10314-6623 | |
| (718) 477-6900 | |
| Not Available |
| Full Name | Mt Sinai Doctors Si-victory Int Med |
|---|---|
| Speciality | Internal Medicine |
| Location | 2315 Victory Blvd, Staten Island, New York |
| Authorized Official Name and Position | Alicia Gresham (VP NETWORK OPERATIONS) |
| Authorized Official Contact | 2126599038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt Sinai Doctors Si-victory Int Med 2315 Victory Blvd Staten Island NY 10314-6623 Ph: (718) 477-6900 | Mt Sinai Doctors Si-victory Int Med 2315 Victory Blvd Staten Island NY 10314-6623 Ph: (718) 477-6900 |
| NPI Number | 1447640024 |
|---|---|
| Provider Enumeration Date | 02/03/2015 |
| Last Update Date | 01/17/2020 |
| Medicare PECOS PAC ID | 8921326570 |
|---|---|
| Medicare Enrollment ID | O20150413000693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447640024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Louis M Emmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306897327 PECOS PAC ID: 5092627604 Enrollment ID: I20031103000369 |
| Provider Name | Akiva Bergman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194782300 PECOS PAC ID: 5597771485 Enrollment ID: I20060301000781 |
| Provider Name | Eliyahu Kopstick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225083546 PECOS PAC ID: 1759485790 Enrollment ID: I20070418000298 |
| Provider Name | Shye S Wortman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275584138 PECOS PAC ID: 3779686803 Enrollment ID: I20080809000011 |
| Provider Name | Seth Brum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144271917 PECOS PAC ID: 5597868620 Enrollment ID: I20080809000025 |
| Provider Name | Sunil Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972679942 PECOS PAC ID: 3274716717 Enrollment ID: I20110322000346 |
| Provider Name | Neven Nassif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235439456 PECOS PAC ID: 5193908127 Enrollment ID: I20110329000113 |
| Provider Name | Melissa A Madalone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720213606 PECOS PAC ID: 6901077791 Enrollment ID: I20110928000296 |
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