Individual
JONATHAN ISSEROW
Active
Individual
JONATHAN ISSEROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA07005300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300129444
RAILROAD MEDICARE - BRIDGEWATER
NJ
01
—
3001294444
RAILROAD MEDICARE - EDISON
NJ
05
—
8506302
—
NJ
Enumeration date
06/24/2005
Last updated
12/06/2016
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