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General NPI Number Information
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NPI Number | 1053949248
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Entity Type | Organization
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Legal Business Name | ALL ISLAND MEDICAL SERVICES. P.C.
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Dates
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Enumeration Date | 04/01/2020
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Last Update Date | 04/01/2020
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Provider Practice Location Address
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Address Line | 1717 VETERANS MEMORIAL HIGHWAY, SUITE 2
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City | ISLANDIA
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State | NY
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Zip | 11749
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Country | US
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Telephone | 929-444-2535
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 VETERANS MEMORIAL HIGHWAY, SUITE 2
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City | ISLANDIA
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State | NY
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Zip | 11749
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Country | US
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Telephone | 929-444-2535
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERIC FANAEE
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Credential | M.D.
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Telephone | 929-444-2535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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