MEDICARE: DR. MANUEL ANTONIO ISER PSY.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	103T00000X	Psychologist	35SI00414700	NJ
2	103T00000X	Psychologist	PY6606	FL
3	103T00000X	Psychologist	015506	NY

General Provider Information

NPI Number	:	1992023055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANUEL ANTONIO ISER PSY.D.

Provider Business Mailing Address
First Line	:	2337 LEMOINE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6211
Country	:	US
Telephone Number	:	201-927-9786
Fax Number	:

Provider Business Practice Location Address
First Line	:	2337 LEMOINE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6211
Country	:	US
Telephone Number	:	201-927-9786
Fax Number	:

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

Provider Enumeration Date	:	05/12/2010
Last Update Date	:	05/12/2010

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