MEDICARE: JAMES B. ISRAEL, M.D., P.C.

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	207RG0100X	Gastroenterology Physician	108902	NY
2	207R00000X	Internal Medicine Physician	108902	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952626566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES B. ISRAEL, M.D., P.C.

Provider Business Mailing Address
First Line	:	222 ROUTE 59
Second Line	:	SUITE 105
City	:	SUFFERN
State	:	NY
Zip	:	10901-5207
Country	:	US
Telephone Number	:	845-368-0338
Fax Number	:	845-368-0376

Provider Business Practice Location Address
First Line	:	222 ROUTE 59
Second Line	:	SUITE 105
City	:	SUFFERN
State	:	NY
Zip	:	10901-5207
Country	:	US
Telephone Number	:	845-368-0338
Fax Number	:	845-368-0376

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES B. ISRAEL
Credential	:	M.D.
Telephone Number	:	845-368-0338

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	04/07/2010

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