Provider Demographics
NPI:1497726491
Name:ISRAEL, JAMES BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BENJAMIN
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:222 ROUTE 59
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5204
Mailing Address - Country:US
Mailing Address - Phone:845-368-0338
Mailing Address - Fax:845-368-0376
Practice Address - Street 1:222 ROUTE 59
Practice Address - Street 2:SUITE 105
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5204
Practice Address - Country:US
Practice Address - Phone:845-368-0338
Practice Address - Fax:845-368-0376
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-28
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY108902207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00447136Medicaid
C11584Medicare UPIN