Organization · NPI-2

Islandia Medical PLLC

· Islandia, NY

NPI number1629695812
StatusActive
Last updated in NPPESJul 3, 2020

Details

NPI
1629695812
Entity type
Organization (NPI-2)
Legal business name
Islandia Medical PLLC
Organization subpart
No
Enumeration date
Jul 3, 2020
Certification date
Jul 3, 2020
Last updated
Jul 3, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208VP0000X ––Yes

Practice location

1726 Veterans Memorial Hwy
Islandia, NY 11749-1512

Phone 516-586-6063

Mailing address

34 Hempstead Tpke
Farmingdale, NY 11735-2034

Authorized official

Mark Schwartz
Owner
5165866063

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