| Organization Name: | ISLAND MEDICAL ASSOCIATES,PA |
| NPI Number: | 1740292119 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PETER O KUPONIYI (INTERNAL MEDICINE) |
| Mailing Address: | 2626 Tilton Rd Egg Harbor Twp |
| State: | NJ US |
| Postal Code: | 082341829 |
| Phone Number: | 6095685000 |
| Fax Number: | 6095685015 |
| NPI Enumeration Date: | 08/13/2006 |
| NPI Last Update Date: | 03/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080A0000X |
| License Number: | 25MA04695100 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |