Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Island Cosmetic and Reconstructive Surgery PLLC

Organization Plastic Surgery Physician · NPI 1013038702

Island Cosmetic and Reconstructive Surgery PLLC is a Plastic Surgery Physician in Mineola, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

190 E Jericho Tpke
Mineola, NY 11501-2033
Phone: (516) 977-9922
Fax: (516) 977-9926
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence 124739 (NY)

Record details

NPI number1013038702
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shannon Boyd — Office Manager · (516) 534-2121
Other names Island Plastic Surgery; Island Plastic Surgery Aesthetic & Wellness
NPI enumeratedApril 2, 2007
Last updated in NPPESFebruary 2, 2026
Certification dateFebruary 2, 2026
Mailing address190 E Jericho Tpke, Mineola, NY 11501-2033

Other providers in Mineola