MEDICARE: ISLAND MEDICAL PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332900000X	Non-Pharmacy Dispensing Site	25MA05374000	NJ

General Provider Information

NPI Number	:	1639587801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISLAND MEDICAL PA

Provider Business Mailing Address
First Line	:	5626 OBERLIN DR
Second Line	:	SUITE 110
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1705
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1812 LONG BEACH BLVD
Second Line	:
City	:	SHIP BOTTOM
State	:	NJ
Zip	:	08008-4443
Country	:	US
Telephone Number	:	609-494-2323
Fax Number	:

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	KENNY HEINE
Credential	:
Telephone Number	:	858-964-1506

Provider Enumeration Date	:	07/31/2014
Last Update Date	:	07/31/2014

Similar Medicare Providers

1427055748 — DR. FREDDIE J DAVIS O.D.
Practice Location Address:

1808 LONG BEACH BLVD
SHIP BOTTOM, NJ
08008-4443

Practice Phone: 609-494-6868
Practice Fax: 609-494-0990

1063491447 — DR. LAUREN SCHARF-SNYDER O.D.
Practice Location Address:

1808 LONG BEACH BLVD
SHIP BOTTOM, NJ
08008-4443

Practice Phone: 609-494-6868
Practice Fax: 609-494-0990

1699754077 — SNYDER& SNYDER& SCHARF-SNYDER PTR
Practice Location Address:

1808 LONG BEACH BLVD
SHIP BOTTOM, NJ
08008-4443

Practice Phone: 609-494-6868
Practice Fax: 609-494-0990

1790764066 — DR. ROBERT SNYDER O.D.
Practice Location Address:

1808 LONG BEACH BLVD
SHIP BOTTOM, NJ
08008-4443

Practice Phone: 609-494-6868
Practice Fax: 609-494-0990

1952416588 — DR. PAUL WILLIAM PROSPERI D.O.
Practice Location Address:

1812 LONG BEACH BLVD
SHIP BOTTOM, NJ
08008-4443

Practice Phone: 609-494-2323
Practice Fax:

1265549539 — ISLAND MEDICAL PROFESSIONAL ASSOCIATION
Practice Location Address:

1812 LONG BEACH BLVD
SHIP BOTTOM, NJ
08008-4443

Practice Phone: 609-494-2323
Practice Fax: 609-494-4141

1821105198 — DR. HARRY L LARKIN M.D.
Practice Location Address:

1812 LONG BEACH BLVD
SHIP BOTTOM, NJ
08008-4443

Practice Phone: 609-494-2323
Practice Fax: 609-494-4141

Directions to “ISLAND MEDICAL PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.