Individual
ALBERTO ISAAC DISLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RSA, OPA-C
Contact information
Practice address
740 BROADWAY STE 605, NEW YORK, NY 10003-9518
(212) 605-1367
Mailing address
740 BROADWAY STE 605, NEW YORK, NY 10003-9518
Taxonomy
Speciality
Code
Description
License number
State
246ZX2200X
Orthopedic Assistant
O000272-01
NY
363AS0400X
Surgical Physician Assistant
Primary
O000272-01
NY
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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