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General NPI Number Information
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NPI Number | 1811084163
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Entity Type | Individual
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Provider Name | MR. GILIL ISAKOV
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Gender | Male
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8611 23RD AVE 2ND FLOOR ROOM 1
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City | BROOKLYN
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State | NY
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Zip | 11214
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Country | US
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Telephone | 212-365-8951
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Fax |
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Provider Business Mailing Address
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Address Line | 679 OCEAN PKWY #APT 6B
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City | BROOKLYN
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State | NY
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Zip | 11230-7808
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Country | US
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Telephone | 212-365-8951
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0032181
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License Number State | NY
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