ISMAIL MEDICINE PLLC NPI 1770317166

NPI Information

NPI: 1770317166
Provider Name: ISMAIL MEDICINE, PLLC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address: 8016 E GENESEE ST
FAYETTEVILLE, NY
ZIP 13066
Phone: (315) 569-1612

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NPI Details

ISMAIL MEDICINE, PLLC is a pediatrics in Fayetteville, NY. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. ISMAIL MEDICINE, PLLC NPI is 1770317166. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8016 E GENESEE ST
FAYETTEVILLE, NY
ZIP 13066-692
Phone: (315) 569-1612

The provider's authorized official is Shareen Ismail .
The authorized official title is Medical Director and has the following contact phone number (315) 569-1612.

The enumeration date for this NPI number is 8/28/2024 and was last updated on 8/28/2024.

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	Primary
1	103TC2200X	Psychologist	Clinical Child & Adolescent	No
2	111NP0017X	Chiropractor	Pediatric Chiropractor	No
3	1223P0221X	Dentist	Pediatric Dentistry	No
4	133VN1004X	Dietitian, Registered	Nutrition, Pediatric	No
5	171100000X	Acupuncturist		No
6	202D00000X	Integrative Medicine		No
7	208000000X	Pediatrics		Yes
8	2080P0006X	Pediatrics	Developmental - Behavioral Pediatrics	No
9	2080P0204X	Pediatrics	Pediatric Emergency Medicine	No
10	2080P0216X	Pediatrics	Pediatric Rheumatology	No
11	2085U0001X	Radiology	Diagnostic Ultrasound	No
12	2251P0200X	Physical Therapist	Pediatrics	No
13	225700000X	Massage Therapist		No
14	225XP0200X	Occupational Therapist	Pediatrics	No
15	2278P3900X	Respiratory Therapist, Certified	Neonatal/Pediatrics	No

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: 11/21/2025

NPI Synchronization or Removal

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