Islip Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

214816 Issued in NY

Legal business name

ISLIP PEDIATRICS PC

Practice address

215 Islip Ave
Islip, NY 11751

Phone

(631) 277-0558

Fax

(631) 277-0978

NPI assigned

Sep 25, 2006

Last updated

Aug 16, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Audrey Chong-Gayle, M.DNPI 1689966343

Title

President

Phone

(631) 277-0558

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Audrey Chong-Gayle, M.D

  • Pediatrics Physician
  • Islip, NY
  • NPI 1689966343
  NPD Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376611200000",
    "number": "1619077070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 ISLIP AVE",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "11751",
            "telephone_number": "631-277-0558",
            "fax_number": "631-277-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 ISLIP AVE",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "11751",
            "telephone_number": "631-277-0558",
            "fax_number": "631-277-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLIP PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2013-08-16",
        "status": "A",
        "authorized_official_last_name": "CHONG-GAYLE",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-277-0558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "214816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02022351",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ami Kim Isaksson, OT
• Island Medical Services PC
• Island Speech Language Pathology, Dina Giancontieri, P.C.
• Islip Dental Associates PC
• Islip Fire District
• Islip Union Free School District
• Cindy Laura Jadoo, MD
• Kelly Anne Jewels
• Devendra P Jhamb
• Shashi B Jhamb, M.D.

• Pediatrics Physician in Islip, NY
• Providers in Islip, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.