Provider Demographics
NPI:1659521524
Name:ISKAROS, BASEM F (MD)
Entity Type:Individual
Prefix:
First Name:BASEM
Middle Name:F
Last Name:ISKAROS
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 1:1 MALCOLM AVE
Mailing Address - Street 2:
Mailing Address - City:TETERBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07608-1011
Mailing Address - Country:US
Mailing Address - Phone:201-393-5789
Mailing Address - Fax:201-462-4706
Practice Address - Street 1:1 MALCOLM AVE
Practice Address - Street 2:
Practice Address - City:TETERBORO
Practice Address - State:NJ
Practice Address - Zip Code:07608-1011
Practice Address - Country:US
Practice Address - Phone:201-393-5789
Practice Address - Fax:201-462-4706
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06088800207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology