Provider Demographics
NPI:1467819540
Name:ROMAN ISAAC MD PLLC
Entity Type:Organization
Organization Name:ROMAN ISAAC MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-308-6622
Mailing Address - Street 1:1320 ADAMS ST STE D-E
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2370
Mailing Address - Country:US
Mailing Address - Phone:201-308-6622
Mailing Address - Fax:201-308-6623
Practice Address - Street 1:1320 ADAMS ST STE D-E
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2370
Practice Address - Country:US
Practice Address - Phone:201-308-6622
Practice Address - Fax:201-308-6623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275010207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty