Provider Demographics
NPI:1750462180
Name:ISAACS, SCOTT (OD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:ISAACS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 RICHMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5988
Mailing Address - Country:US
Mailing Address - Phone:718-698-5622
Mailing Address - Fax:
Practice Address - Street 1:901 AVENUE OF THE AMERICAS
Practice Address - Street 2:HERALD SQUARE OPTOMETRY/LENSCRAFTERS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3505
Practice Address - Country:US
Practice Address - Phone:212-967-4177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2011-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003989-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist