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General NPI Number Information
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NPI Number | 1437580461
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Entity Type | Organization
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Legal Business Name | ISLAND MEDICAL CARE, PLLC
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Dates
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Enumeration Date | 12/02/2013
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 202-28 45TH AVE
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City | BAYSIDE
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State | NY
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Zip | 11361-2540
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Country | US
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Telephone | 631-495-8038
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 936
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City | COMMACK
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State | NY
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Zip | 11725
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Country | US
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Telephone | 631-495-8038
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. AKBAR A. KHAN
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Credential | M.D.
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Telephone | 631-495-8038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 233372
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License Number State | NY
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