Organization
ISLIP PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUDREY CHONG-GAYLE M.D (PRESIDENT)
(631) 277-0558
Entity
Organization
Contact information
Practice address
215 ISLIP AVE, ISLIP, NY 11751
(631) 277-0558
(631) 277-0978
Mailing address
215 ISLIP AVE, ISLIP, NY 11751
(631) 277-0558
(631) 277-0978
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
214816
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02022351
—
NY
Enumeration date
09/25/2006
Last updated
08/16/2013
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