Island Neurology PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

181810 Issued in NY

Legal business name

ISLAND NEUROLOGY PC

Practice address

2805 Veterans Memorial Hwy
Suite 9
Ronkonkoma, NY 11779-7647

Phone

(631) 738-8300

Fax

(631) 738-8500

NPI assigned

Oct 27, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Bonnie Gruber

Title

Billing Dept

Phone

(631) 738-8300

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1073813770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 9",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797647",
            "telephone_number": "631-738-8300",
            "fax_number": "631-738-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 9",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797647",
            "telephone_number": "631-738-8300",
            "fax_number": "631-738-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "GRUBER",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "BILLING DEPT",
        "authorized_official_telephone_number": "631-738-8300",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "181810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Infinity Pharma Group L.L.C.
• Alyssa Inzerillo, SLP
• Iron Clad Medical Diagnostic P.C.
• Island Interventions
• Island Mobility Physical Therapy P.C.
• Belinda Izevbizua
• Osahon Izevbizua
• Osarose Izevbizua
• Dana Jahn, MS PT
• Ankit A Jain, DDS

• Specialist in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.