Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | 0024631 | NY |
NPI | 1447397476 |
---|---|
Provider Name | Mr. Israel D Geisler |
First Address | Brooklyn, NY 11234-5139 |
Second Address | Brooklyn, NY 11234-5139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 04/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00691016 | (05) | NY |