Provider Demographics
NPI:1952626566
Name:JAMES B. ISRAEL, M.D., P.C.
Entity Type:Organization
Organization Name:JAMES B. ISRAEL, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:ISRAEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-368-0338
Mailing Address - Street 1:222 ROUTE 59
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5207
Mailing Address - Country:US
Mailing Address - Phone:845-368-0338
Mailing Address - Fax:845-368-0376
Practice Address - Street 1:222 ROUTE 59
Practice Address - Street 2:SUITE 105
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5207
Practice Address - Country:US
Practice Address - Phone:845-368-0338
Practice Address - Fax:845-368-0376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108902207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00447136Medicaid
NYC11584Medicare UPIN
NY626021Medicare PIN