# ISLAND OF HEALTH MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073782504
- **Authorized official:** MRS. ILYA KLEYN MD (OWNER)
- **Authorized official phone:** (212) 686-6700

## Contact information

- **Practice address:** 114 32 ROCKAWAY BEACH BLVD, ROCKAWAY PARK, NY 11694
- **Practice address phone:** (718) 318-0090
- **Mailing address:** 114 32 ROCKAWAY BEACH BLVD, ROCKAWAY PARK, NY 11694
- **Mailing address phone:** (718) 318-0090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 228891 | NY | Yes |
| 207R00000X | Internal Medicine Physician | 207201 | NY | — |
| 207RC0000X | Cardiovascular Disease Physician | 242000 | NY | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | 215006 | NY | — |

## Other

- **Enumeration date:** 02/28/2008
- **Last updated:** 02/28/2008