Provider Demographics
NPI:1952627697
Name:ISOPO, ANDREW L (MD)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:L
Last Name:ISOPO
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 1:25254 LEEDS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1847
Mailing Address - Country:US
Mailing Address - Phone:646-761-8314
Mailing Address - Fax:
Practice Address - Street 1:25254 LEEDS RD
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1847
Practice Address - Country:US
Practice Address - Phone:646-761-8314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270730207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine