Provider Demographics
NPI:1851832026
Name:ISAYEV, MORAN
Entity Type:Individual
Prefix:
First Name:MORAN
Middle Name:
Last Name:ISAYEV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BELL POINT DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6328
Mailing Address - Country:US
Mailing Address - Phone:718-496-2294
Mailing Address - Fax:
Practice Address - Street 1:22 BELL POINT DR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6328
Practice Address - Country:US
Practice Address - Phone:718-496-2294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator