Provider Demographics
NPI:1497182687
Name:ISAACS, TAMEEKA
Entity Type:Individual
Prefix:
First Name:TAMEEKA
Middle Name:
Last Name:ISAACS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10771 WATSON PL
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-2510
Mailing Address - Country:US
Mailing Address - Phone:940-224-4689
Mailing Address - Fax:
Practice Address - Street 1:10771 WATSON PL
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11433-2510
Practice Address - Country:US
Practice Address - Phone:940-224-4689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY671547-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse