MEDICARE: DR. MARINA ISAKOVA 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	208100000X	Physical Medicine & Rehabilitation Physician	238803	NY

General Provider Information

NPI Number	:	1942252556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARINA ISAKOVA M.D.

Provider Business Mailing Address
First Line	:	3030 OCEAN AVE
Second Line	:	APT. 4F
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3363
Country	:	US
Telephone Number	:	347-312-2052
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 OCEAN AVE
Second Line	:	APT. 4F
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3363
Country	:	US
Telephone Number	:	347-312-2052
Fax Number	:

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	04/04/2014

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