Provider Demographics
NPI:1922145739
Name:ISENBERGH, ELENA (MD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:ISENBERGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 18TH ST NW
Mailing Address - Street 2:APT 109
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1358
Mailing Address - Country:US
Mailing Address - Phone:202-701-0060
Mailing Address - Fax:202-462-4394
Practice Address - Street 1:1545 18TH ST NW
Practice Address - Street 2:APT 109
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1345
Practice Address - Country:US
Practice Address - Phone:202-701-0060
Practice Address - Fax:202-462-4394
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2009-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 98063207RI0200X
MDD0067540207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0067540OtherMD LICENSE
DCMD037238OtherDC LICENSE