Provider Demographics
NPI:1477195139
Name:ISRAEL, STEVEN D (PT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HENRY CT
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2304
Mailing Address - Country:US
Mailing Address - Phone:516-223-8679
Mailing Address - Fax:
Practice Address - Street 1:6 HENRY CT
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-2304
Practice Address - Country:US
Practice Address - Phone:516-223-8679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008528225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist