# ISLAND PHYSICIAN SERVICES, PLLC

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

## Provider details

- **NPI number:** 1669738746
- **Authorized official:** NICHOLAS TARRICONE MD MHA FACOG (OWNER)
- **Authorized official phone:** (516) 678-4000

## Contact information

- **Practice address:** 2000 N VILLAGE AVE, SUITE 109, ROCKVILLE CENTRE, NY 11570-1078
- **Practice address phone:** (516) 678-4000
- **Practice address fax:** (516) 678-9573
- **Mailing address:** 2000 N VILLAGE AVE, SUITE 109, ROCKVILLE CENTRE, NY 11570-1078
- **Mailing address phone:** (516) 678-4000
- **Mailing address fax:** (516) 678-9573

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 176675 | NY | Yes |

## Other

- **Enumeration date:** 04/03/2012
- **Last updated:** 04/03/2012