Provider Demographics
NPI:1508999202
Name:ISRAEL, RANY (PA)
Entity Type:Individual
Prefix:MR
First Name:RANY
Middle Name:
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N VILLAGE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2300
Mailing Address - Country:US
Mailing Address - Phone:516-766-2929
Mailing Address - Fax:516-766-7728
Practice Address - Street 1:200 N VILLAGE AVE STE 300
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2300
Practice Address - Country:US
Practice Address - Phone:516-766-2929
Practice Address - Fax:516-766-7728
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007307363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical