Provider Demographics
NPI:1821248345
Name:ISEDA, TSUTOMU (MD)
Entity Type:Individual
Prefix:DR
First Name:TSUTOMU
Middle Name:
Last Name:ISEDA
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 1:37 REDCLIFFE AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-1611
Mailing Address - Country:US
Mailing Address - Phone:732-718-4920
Mailing Address - Fax:
Practice Address - Street 1:37 REDCLIFFE AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-1611
Practice Address - Country:US
Practice Address - Phone:732-718-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program