Organization
ISLAND ORTHOPAEDICS & SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY NIZICH (ADMINISTRATOR)
(516) 798-0111
Entity
Organization
Contact information
Practice address
660 BROADWAY, MASSAPEQUA, NY 11758-2312
(516) 798-0111
(516) 798-3631
Mailing address
660 BROADWAY, MASSAPEQUA, NY 11758-2312
(516) 798-0111
(516) 798-3631
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
11/01/2006
Last updated
12/14/2009
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