Provider Demographics
NPI:1396948188
Name:ERNEST L ISAACSON DPM PC
Entity type:Organization
Organization Name:ERNEST L ISAACSON DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAACSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-420-6002
Mailing Address - Street 1:30 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3801
Mailing Address - Country:US
Mailing Address - Phone:212-420-6002
Mailing Address - Fax:646-405-0192
Practice Address - Street 1:30 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3801
Practice Address - Country:US
Practice Address - Phone:212-420-6002
Practice Address - Fax:646-405-0192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005935213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02478384Medicaid
NY5957930001Medicare NSC
NYU95565Medicare UPIN
NYPH6511Medicare ID - Type Unspecified