Individual
JOSE ISIDRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 LINCOLN HWY, # 109, EDISON, NJ 08820-3961
(732) 318-6869
(732) 494-9112
Mailing address
28 NEW BROOKLYN RD, EDISON, NJ 08817-2254
(732) 318-6869
(732) 494-9112
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA04749000
NJ
208VP0014X
Interventional Pain Medicine Physician
25MA04749000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4536908
—
NJ
Enumeration date
02/25/2006
Last updated
12/01/2017
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