Healthcare Provider Details

I. General information

NPI: 1497825434
Provider Name (Legal Business Name): ISAAC KREIZMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 08/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5223 9TH AVE
BROOKLYN NY
11220
US

IV. Provider business mailing address

5223 9TH AVE
BROOKLYN NY
11220-2913
US

V. Phone/Fax

Practice location:
  • Phone: 718-431-2959
  • Fax: 718-431-2974
Mailing address:
  • Phone: 718-431-2959
  • Fax: 718-431-2974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number206647
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number206647
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number206647
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: