Island of Health Medical PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

215006 Issued in NY

Legal business name

ISLAND OF HEALTH MEDICAL PC

Practice address

8002 165 St. Union TNPK
Jamaica, NY 11432

Phone

(718) 380-7000

Fax

(212) 791-3388

NPI assigned

Oct 12, 2006

Last updated

Aug 22, 2020By 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. Ilya Kleyn

Title

MD

Phone

(917) 554-5735

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750470514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8002 165 ST. UNION TNPK",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-380-7000",
            "fax_number": "212-791-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8002 165 ST. UNION TNPK",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-380-7000",
            "fax_number": "212-791-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND OF HEALTH MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLEYN",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "917-554-5735",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "215006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02091596",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ratul Islam, MD
• Raveena Islam, LMHC
• Shaniun Islam
• Shanzida Islam
• Island of Health Medical PC
• Haider Ismail
• Fady Israel
• Patricia Israel
• Israelshining Star Incorporated
• Ortal Israilov, NP

• Primary Care Clinic/Center in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Primary Care 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.