Organization
ISLAND MUSCULOSKELETAL CARE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY DOUGLAS JUPITER MD (PRESIDENT)
(516) 374-6838
Entity
Organization
Contact information
Practice address
3500 NOSTRAND AVE, BROOKLYN, NY 11229-5107
(718) 332-3600
(718) 332-3856
Mailing address
PO BOX 360, HEWLETT, NY 11557-0360
(516) 374-6838
(516) 374-2362
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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