MEDICARE: DR. LEONID ISAKOV MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	245705	NY

General Provider Information

NPI Number	:	1558558122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONID ISAKOV MD

Provider Business Mailing Address
First Line	:	2792 OCEAN AVE FL 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4731
Country	:	US
Telephone Number	:	718-942-4222
Fax Number	:	347-533-6749

Provider Business Practice Location Address
First Line	:	2792 OCEAN AVE FL 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4731
Country	:	US
Telephone Number	:	718-942-4222
Fax Number	:	347-533-6749

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2007
Last Update Date	:	05/31/2018

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