Provider Demographics
NPI:1740462555
Name:ISAAC, NEIMA I (DSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:NEIMA
Middle Name:I
Last Name:ISAAC
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E 82ND ST
Mailing Address - Street 2:# 19G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2703
Mailing Address - Country:US
Mailing Address - Phone:212-988-1754
Mailing Address - Fax:646-290-7563
Practice Address - Street 1:240 E 82ND ST
Practice Address - Street 2:# 19G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2703
Practice Address - Country:US
Practice Address - Phone:212-988-1754
Practice Address - Fax:646-290-7563
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO14314-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN53221Medicare PIN