NPI 1013038702

Island Cosmetic and Reconstructive Surgery PLLC

Organisation Plastic Surgery Physician Mineola, NY

Practice location

Address: 190 E Jericho Tpke, Mineola, NY 11501-2033
Phone: (516) 977-9922
Fax: (516) 977-9926

Authorised official

Name: Shannon Boyd
Title: Office Manager
Phone: (516) 534-2121

Registered specialties

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X Licence 124739 (NY)

Other Plastic Surgery providers in New York →

Registry record

NPI: 1013038702
Entity type: Organization
NPI issued: 2 Apr 2007
Record last updated: 2 Feb 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.