Individual
MR. GRIGORY ISACC KIZELSHTEYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
220 WESTCHESTER AVENUE, WHITE PLAINS, NY 10604
(914) 289-1507
(914) 289-0937
Mailing address
220 WESTCHESTER AVENUE, WHITE PLAINS, NY 10604
(914) 289-1507
(914) 289-0937
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
1661111
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
1661111
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01216375
—
NY
01
—
91389
NY GOVERNMENT
—
01
—
P1253384
OXFORD
—
Enumeration date
06/14/2006
Last updated
06/22/2010
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