Provider Demographics
NPI:1558558122
Name:ISAKOV, LEONID (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONID
Middle Name:
Last Name:ISAKOV
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 1:2792 OCEAN AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4731
Mailing Address - Country:US
Mailing Address - Phone:718-942-4222
Mailing Address - Fax:347-533-6749
Practice Address - Street 1:2792 OCEAN AVE FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4731
Practice Address - Country:US
Practice Address - Phone:718-942-4222
Practice Address - Fax:347-533-6749
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245705208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics