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General NPI Number Information
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NPI Number | 1376991414
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Entity Type | Organization
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Legal Business Name | ISLAND URGENT CARE PLLC
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Dates
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Enumeration Date | 05/31/2016
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Last Update Date | 05/31/2016
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Provider Practice Location Address
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Address Line | 2310 HEMPSTEAD TPKE
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City | EAST MEADOW
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State | NY
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Zip | 11554-2035
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Country | US
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Telephone | 516-346-5090
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Fax | 516-346-5091
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Provider Business Mailing Address
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Address Line | 2310 HEMPSTEAD TPKE
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City | EAST MEADOW
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State | NY
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Zip | 11554-2035
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Country | US
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Telephone | 516-346-5090
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Fax | 516-346-5091
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MR. MICHAEL LEE
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Credential | M.D.
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Telephone | 516-346-5090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 203155
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License Number State | NY
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