Provider Demographics
NPI:1508010273
Name:ISRAEL, ANTON (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTON
Middle Name:
Last Name:ISRAEL
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 1:320 FAIRMOUNT AVE
Mailing Address - Street 2:APT.#207
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-4845
Mailing Address - Country:US
Mailing Address - Phone:201-238-6124
Mailing Address - Fax:
Practice Address - Street 1:270-05 76TH AVENUE
Practice Address - Street 2:LONG ISLAND JEWISH MEDICAL CENTER
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:718-470-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYAN0768917 I 07208600000X
NYAL4849622 J14208600000X
NYMMIS00243903208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery