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General NPI Number Information
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NPI Number | 1649394123
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Entity Type | Individual
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Provider Name | FIKRY W ISAAC MD
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 501 GEORGE ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1161
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Country | US
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Telephone | 732-524-3404
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CRYSTAL GLENN CT
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City | FLEMINGTON
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State | NJ
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Zip | 08822-2649
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Country | US
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Telephone | 908-806-4929
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 50502
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License Number State | NJ
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