MEDICARE: DR. ISAAC ROBERT NAGEL M.D.

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	2084P0802X	Addiction Psychiatry Physician	25MA0826900	NJ
2	2084P0800X	Psychiatry Physician	54013020	WI
3	2084P0800X	Psychiatry Physician	295171	NY
4	2084P0800X	Psychiatry Physician	C164012	CA

General Provider Information

NPI Number	:	1831395300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISAAC ROBERT NAGEL M.D.

Provider Business Mailing Address
First Line	:	109 N 12TH ST STE 704
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-1002
Country	:	US
Telephone Number	:	844-384-2779
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 N 12TH ST STE 704
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-1002
Country	:	US
Telephone Number	:	844-384-2779
Fax Number	:

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

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	09/30/2024

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