Healthcare Provider Details

I. General information

NPI: 1952626566
Provider Name (Legal Business Name): JAMES B. ISRAEL, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 ROUTE 59 SUITE 105
SUFFERN NY
10901-5207
US

IV. Provider business mailing address

222 ROUTE 59 SUITE 105
SUFFERN NY
10901-5207
US

V. Phone/Fax

Practice location:
  • Phone: 845-368-0338
  • Fax: 845-368-0376
Mailing address:
  • Phone: 845-368-0338
  • Fax: 845-368-0376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number108902
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number108902
License Number StateNY

VIII. Authorized Official

Name: DR. JAMES B. ISRAEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 845-368-0338