Organization · Type 2 NPI

Island Cosmetic and Reconstructive Surgery PLLC

Plastic Surgery Physician · Mineola, NY

NPI number 1013038702 Active

Practice location

190 E Jericho Tpke
Mineola, NY 11501-2033

Fax (516) 977-9926

Specialties and licenses

Taxonomy	Code	License
Plastic Surgery Physician Primary	208200000X	124739 (NY)

Plastic Surgery Physician: A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to b…

8 other providers at this address

NPI record

NPI: 1013038702
Entity type: Organization (Type 2)
Issued: Apr 2, 2007
Last updated: Feb 2, 2026
Status: Active

Other names

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Island Plastic Surgery · doing business as
Island Plastic Surgery Aesthetic & Wellness · doing business as

Authorized official

Ms. Shannon Boyd
Office Manager
(516) 534-2121

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About NPI 1013038702

Island Cosmetic and Reconstructive Surgery PLLC's National Provider Identifier is 1013038702, issued on Apr 2, 2007. The primary taxonomy on file is Plastic Surgery Physician (208200000X), and the practice location is in Mineola, NY. The record was last updated on Feb 2, 2026.