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Individual

ISAAC IKE BOUSKILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(718) 670-1100
Mailing address
1450 E 7TH ST, BROOKLYN, NY 11230-5711
(917) 294-4220

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
029850-01
NY

Other

Enumeration date
04/10/2023
Last updated
04/10/2023
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