Individual
DR. MARJORIE J. ISDITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
20 HICKSVILLE ROAD, MASSAPEQUA, NY 11758
(516) 795-5700
(516) 795-5701
Mailing address
20 HICKSVILLE ROAD, MASSAPEQUA, NY 11758
(516) 795-5700
(516) 795-5701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
197492
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1392024
UNITED HEALTH
NY
01
—
6012892
GHI
NY
01
—
617701
AETNA
NY
01
—
650491
BLUE CROSS
NY
01
—
65911
VYTRA
NY
01
—
DA48287
MDNY
NY
01
—
P403153
OXFORD
NY
Enumeration date
06/15/2005
Last updated
04/24/2008
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