Provider Demographics
NPI:1992837637
Name:ISLAND ENDOCRINOLOGY,P.C.
Entity Type:Organization
Organization Name:ISLAND ENDOCRINOLOGY,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-979-9700
Mailing Address - Street 1:221 MOUNT PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-4831
Mailing Address - Country:US
Mailing Address - Phone:631-979-9700
Mailing Address - Fax:631-265-8042
Practice Address - Street 1:221 MOUNT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-4831
Practice Address - Country:US
Practice Address - Phone:631-979-9700
Practice Address - Fax:631-265-8042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH48379Medicare UPIN
NYB11044Medicare UPIN
NYWEE061Medicare ID - Type Unspecified