# ISLAND MEDICAL ASSOCIATES,PA

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

## Provider details

- **NPI number:** 1740292119
- **Authorized official:** DR. PETER O KUPONIYI MD (INTERNAL MEDICINE)
- **Authorized official phone:** (609) 568-5000

## Contact information

- **Practice address:** 2626 TILTON RD, EGG HARBOR TWP, NJ 08234-1829
- **Practice address phone:** (609) 568-5000
- **Practice address fax:** (609) 568-5015
- **Mailing address:** 2626 TILTON RD, EGG HARBOR TWP, NJ 08234-1829
- **Mailing address phone:** (609) 568-5000
- **Mailing address fax:** (609) 568-5015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 25MA05948800 | NJ | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 25MA04695100 | NJ | — |

## Other

- **Enumeration date:** 08/13/2006
- **Last updated:** 03/08/2011