Provider Demographics
NPI:1124890298
Name:NORTH ISLAND MEDICAL PLLC
Entity type:Organization
Organization Name:NORTH ISLAND MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CESARE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPONIERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-252-4765
Mailing Address - Street 1:128 MALVERNE AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:128 MALVERNE AVE
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-1442
Practice Address - Country:US
Practice Address - Phone:718-252-4765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care