Island Physiatry, PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

208578 Issued in NY

Legal business name

ISLAND PHYSIATRY, PC

Practice address

700 Patchogue Yaphank Rd Ste 32
Medford, NY 11763-2235

Phone

(631) 425-1980

NPI assigned

Jun 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sam Song, MD

Title

President

Phone

(631) 425-1980

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619179744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1487",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117470287",
            "telephone_number": "631-425-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PATCHOGUE YAPHANK RD STE 32",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632235",
            "telephone_number": "631-425-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND PHYSIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-425-1980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "208578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Imran, P.T.
• Integrated Counseling, PLLC
• Jenna Interligi, L.P.N
• Island Medical of Medford, LLP
• Island Musculoskeletal Care, M.D., P.C.
• IV Glow and Wellness LLC
• Jay Iype, M.D.
• J Adelson Horizon Health NP in Psychiatry PLLC
• J&P Watson
• Stephanie Jackson, LPN

• Physical Medicine & Rehabilitation Physician in Medford, NY
• Providers in Medford, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.