Provider Demographics
NPI:1992023055
Name:ISER, MANUEL ANTONIO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:ANTONIO
Last Name:ISER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 LEMOINE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6211
Mailing Address - Country:US
Mailing Address - Phone:201-927-9786
Mailing Address - Fax:
Practice Address - Street 1:2337 LEMOINE AVE
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6211
Practice Address - Country:US
Practice Address - Phone:201-927-9786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00414700103T00000X
FLPY6606103T00000X
NY015506103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist