Provider Demographics
NPI:1811084163
Name:ISAKOV, GILIL
Entity type:Individual
Prefix:MR
First Name:GILIL
Middle Name:
Last Name:ISAKOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 OCEAN PKWY
Mailing Address - Street 2:#APT 6B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7808
Mailing Address - Country:US
Mailing Address - Phone:212-365-8951
Mailing Address - Fax:
Practice Address - Street 1:8611 23RD AVE
Practice Address - Street 2:2ND FLOOR ROOM 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214
Practice Address - Country:US
Practice Address - Phone:212-365-8951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0032181171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist