Comprehensive Island Medical Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COMPREHENSIVE ISLAND MEDICAL CARE LLC

Practice address

6080 Jericho Tpke Ste 205
Commack, NY 11725-2808

Phone

(631) 486-4834

Fax

(631) 486-5029

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Yanira Raza, MD

Title

Physician

Phone

(631) 486-4834

Specialties & licenses 1

Addresses

Other names 1

• Comprehensive Island Medical Care LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olubunmi Abiye Bolaji, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Commack, NY
  • NPI 1619100633
  NPD

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1154435576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6080 JERICHO TPKE STE 205",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252808",
            "telephone_number": "631-486-4834",
            "fax_number": "631-486-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 JERICHO TPKE STE 205",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252808",
            "telephone_number": "631-486-4834",
            "fax_number": "631-486-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE ISLAND MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "RAZA",
        "authorized_official_first_name": "YANIRA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-486-4834",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Island Medical Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Edward M Condon, MD
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• Kristen Ann Conner, LMHC
• Elizabeth Connolly

• Internal Medicine Physician in Commack, NY
• Providers in Commack, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.