Organization
ISLAND COSMETIC AND RECONSTRUCTIVE SURGERY PLLC
Active
Other names
Island Plastic Surgery, Island Plastic Surgery Aesthetic & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON BOYD (OFFICE MANAGER)
(516) 534-2121
Entity
Organization
Contact information
Practice address
190 E JERICHO TPKE, MINEOLA, NY 11501-2033
(516) 977-9922
(516) 977-9926
Mailing address
190 E JERICHO TPKE, MINEOLA, NY 11501-2033
(516) 977-9922
(516) 977-9926
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
124739
NY
Other
Enumeration date
04/02/2007
Last updated
02/02/2026
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