Individual
THEODORE N ISSEKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5518 STATE ROUTE 55, LIBERTY, NY 12754
(845) 292-3011
(845) 292-1821
Mailing address
5518 STATE ROUTE 55, LIBERTY, NY 12754
(845) 292-3011
(845) 292-1821
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
117110
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00248233
—
NY
Enumeration date
08/09/2005
Last updated
01/05/2011
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