Provider Demographics
NPI:1497825434
Name:KREIZMAN, ISAAC (MD)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:KREIZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5223 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2913
Mailing Address - Country:US
Mailing Address - Phone:718-431-2959
Mailing Address - Fax:718-431-2974
Practice Address - Street 1:5223 9TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220
Practice Address - Country:US
Practice Address - Phone:718-431-2959
Practice Address - Fax:718-431-2974
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206647174400000X, 208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No174400000XOther Service ProvidersSpecialist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000115621OtherGHI HMO
NY2799275OtherGHI
NY100200195002OtherAMERICHOICE
NY02023729Medicaid
NY20664701OtherNEIGHBORHOOD HEALTH PROVIDERS
P2789988OtherOXFORD
NY07138GOtherMEDICARE GHI
NY171748OtherELDERPLAN
NYP00329271OtherRAILROAD MEDICARE
NY3622690OtherAETNA HMO
NY7100231OtherAETNA PPO
NY206647-0BOtherWORKERS COMP
NY3C5861OtherHEALTHNET
NY206647OtherHIP
NY0692J1OtherEMPIRE BC/BS OF NY
NY10209742OtherAMERIGROUP
NY000000115621OtherGHI HMO
NY206647-0BOtherWORKERS COMP
NY26Z54EU401Medicare PIN