Provider Demographics
NPI:1932343753
Name:ISA, FLONZA (MD)
Entity Type:Individual
Prefix:
First Name:FLONZA
Middle Name:
Last Name:ISA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 MULBERRY ST
Mailing Address - Street 2:APT 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3751
Mailing Address - Country:US
Mailing Address - Phone:646-248-8749
Mailing Address - Fax:
Practice Address - Street 1:505 E 70TH ST
Practice Address - Street 2:BOX 148
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-746-9663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2018-07-13
Deactivation Date:2018-06-19
Deactivation Code:
Reactivation Date:2018-07-10
Provider Licenses
StateLicense IDTaxonomies
NY260646207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease