Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 2779361 | NY |
NPI | 1639321847 |
---|---|
Provider Name | Marleine Ishak |
First Address | Bronx, NY 10467-2800 |
Second Address | Bronx, NY 10467-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 25/05/2017 |