Provider Demographics
NPI:1891997763
Name:ISENBERG, ARTHUR D (OD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:D
Last Name:ISENBERG
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 1:133 SARATOGA RD APT X8
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12302-5914
Mailing Address - Country:US
Mailing Address - Phone:518-393-8372
Mailing Address - Fax:
Practice Address - Street 1:971 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3503
Practice Address - Country:US
Practice Address - Phone:518-458-2112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC002439152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist