Organization
ISLAND SURGICAL & VASCULAR GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY DAVID COHEN M.D. (PRESIDENT)
(631) 581-4400
Entity
Organization
Contact information
Practice address
15 PARK AVE, BAY SHORE, NY 11706-7381
(631) 581-4400
(631) 277-3750
Mailing address
15 PARK AVE, BAY SHORE, NY 11706-7381
(631) 581-4400
(631) 277-3750
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00664668
—
NY
Enumeration date
05/31/2006
Last updated
12/01/2009
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