Individual
JASMINE SAMANTHA ISAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
374 STOCKHOLM ST, BROOKLYN, NY 11237-4006
(718) 963-7272
Mailing address
20 DUBOIS AVE, AMITYVILLE, NY 11701-1533
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
021247
NY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
021247
NY
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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