Provider Demographics
NPI:1619241056
Name:ISLAND ENDOCRINOLOGY AND DIABETES PC
Entity Type:Organization
Organization Name:ISLAND ENDOCRINOLOGY AND DIABETES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZINOVIY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABELEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-459-2589
Mailing Address - Street 1:1029 FORDHAM LN
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1013
Mailing Address - Country:US
Mailing Address - Phone:917-459-2589
Mailing Address - Fax:
Practice Address - Street 1:2965 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3204
Practice Address - Country:US
Practice Address - Phone:516-453-0909
Practice Address - Fax:516-453-0903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244839207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty