| Island Comprehensive Care Inc. | |
|
6144 Route 25a Ste 13 Wading River NY 11792-2008 | |
| (917) 225-2165 | |
| Not Available |
| Full Name | Island Comprehensive Care Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 6144 Route 25a Ste 13, Wading River, New York |
| Authorized Official Name and Position | Neil Jaglall (MEDICAL DOCTOR) |
| Authorized Official Contact | 6318862844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Island Comprehensive Care Inc. 6144 Route 25a Ste 13 Wading River NY 11792-2008 Ph: (917) 225-2165 | Island Comprehensive Care Inc. 6144 Route 25a Ste 13 Wading River NY 11792-2008 Ph: (917) 225-2165 |
| NPI Number | 1285104257 |
|---|---|
| Provider Enumeration Date | 12/03/2018 |
| Last Update Date | 02/14/2019 |
| Medicare PECOS PAC ID | 5799024261 |
|---|---|
| Medicare Enrollment ID | O20190227001581 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285104257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Neil D Jaglall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811132632 PECOS PAC ID: 1355511494 Enrollment ID: I20110830000113 |
| Provider Name | Michael J Tadros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528366267 PECOS PAC ID: 4486809068 Enrollment ID: I20130305000411 |
| Provider Name | Juan Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689963753 PECOS PAC ID: 7517185978 Enrollment ID: I20140826002018 |
| Provider Name | Amita Vipul Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205447224 PECOS PAC ID: 5597170035 Enrollment ID: I20210216001727 |
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