Hollis Medical PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

243430 Issued in NY

Legal business name

HOLLIS MEDICAL PC

Practice address

8786 188TH St
Hollis, NY 11423-1131

Phone

(718) 480-6882

Fax

(718) 217-7653

NPI assigned

Apr 9, 2014

Organization subpart

No

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

Authorized official

Name

Dr. MD Mahbubul Islam, MDNPI 1285758276

Title

Ceo/President

Phone

(718) 480-6882

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• MD Mahbubul Islam, M.D.

  • Family Medicine Physician
  • Hollis, NY
  • NPI 1285758276
  NPD (past) Authorized official

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1356760052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8786 188TH ST",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231131",
            "telephone_number": "718-480-6882",
            "fax_number": "718-217-7653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8786 188TH ST",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231131",
            "telephone_number": "718-480-6882",
            "fax_number": "718-217-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLIS MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "ISLAM",
        "authorized_official_first_name": "MD",
        "authorized_official_middle_name": "MAHBUBUL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "718-480-6882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "243430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02866613",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hollis Advanced Dental Care P.C.
• Hollis Chemists LLC
• Hollis Drugs Inc
• Hollis Medical Care, P.C.
• Hollis Medical Office
• Hollis Multi-Specialty Dental Group P.C
• Hollis Operating Co LLC
• Hollis Park Manor Nursing Home, Inc.
• Hollis Pediatrics
• Hollis Primary Care P.C.

• Family Medicine Physician in Hollis, NY
• Providers in Hollis, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.