| Organization Name: | NORTH ISLAND MEDICAL, P.C. |
| NPI Number: | 1548292956 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MANUEL TALAVERA (OWNER/PRESIDENT) |
| Mailing Address: | 1575 Hillside Ave Suite Ll1 New Hyde Park |
| State: | NY US |
| Postal Code: | 110402501 |
| Phone Number: | 5166167600 |
| Fax Number: | 5166164821 |
| NPI Enumeration Date: | 07/07/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 099616 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |