ISLAND SURGICAL & VASCULAR GROUP P.C. NPI 1639116759

NPI Information

NPI: 1639116759
Provider Name: ISLAND SURGICAL & VASCULAR GROUP, P.C.
Classification: Surgery - 208600000X
Entity Type: Organization
CLIA Number: 33D2010534
Address: 15 PARK AVE
BAY SHORE, NY
ZIP 11706
Phone: (631) 581-4400

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NPI Details

ISLAND SURGICAL & VASCULAR GROUP, P.C. is a surgery in Bay Shore, NY. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. ISLAND SURGICAL & VASCULAR GROUP, P.C. NPI is 1639116759. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

15 PARK AVE
BAY SHORE, NY
ZIP 11706-381
Phone: (631) 581-4400
Fax: (631) 277-3750

The provider's authorized official is Bradley David Cohen .
The authorized official title is President and has the following contact phone number (631) 581-4400.

The CLIA number assigned to this NPI record is 33D2010534 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2006 and was last updated on 12/1/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	00664668	MEDICAID	NEW YORK
2	W01511	MEDICARE PIN	NEW YORK
3	W01511	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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