South Island Pediatrics, P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

148634 Issued in NY

Legal business name

SOUTH ISLAND PEDIATRICS, P.C.

Practice address

86 Carman Ave
Cedarhurst, NY 11516-1905

Phone

(516) 569-0500

Fax

(516) 569-0570

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mitchell I Weiler, M.D.

Title

President

Phone

(516) 569-0500

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639233307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 CARMAN AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115161905",
            "telephone_number": "516-569-0500",
            "fax_number": "516-569-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 CARMAN AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115161905",
            "telephone_number": "516-569-0500",
            "fax_number": "516-569-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ISLAND PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEILER",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-569-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "148634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00890588",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rochelle Barbara Somer, LCSW
• Giovanni Soto, D.C.
• South Island Orthopaedic Group, P.C.
• South Island Orthopedics, P.C.
• South Island Pediatrics, N.Y.C., P.C.
• South Island Periodontics and Implantology PLLC
• South Shore at Home Physical Therapy PLLC
• South Shore Foot Care P.C.
• South Shore Gastroenterology PC
• South Shore Psychological Services PLLC

• Clinic/Center in Cedarhurst, NY
• Providers in Cedarhurst, NY by specialty
• Clinic/Center 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.