Organization
ISLAND MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN BOURLA M.D. (MANAGING PARTNER)
(516) 433-3600
Entity
Organization
Contact information
Practice address
789 OLD COUNTRY RD, PLAINVIEW, NY 11803-4907
(516) 433-3600
(516) 433-9490
Mailing address
789 OLD COUNTRY RD, PLAINVIEW, NY 11803-4907
(516) 433-3600
(516) 433-9490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00100918
—
NY
Enumeration date
08/19/2006
Last updated
09/11/2025
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