Individual
DR. ROGER ISHAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 BEEKMAN ST., CVPH CARDIOLOGY, PLATTSBURGH, NY 12901
(518) 563-2404
Mailing address
75 BEEKMAN ST., CVPH CARDIOLOGY, PLATTSBURGH, NY 12901
(518) 563-2404
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD429478
PA
207RC0000X
Cardiovascular Disease Physician
042.0013217
VT
207RC0000X
Cardiovascular Disease Physician
Primary
241066
NY
390200000X
Student in an Organized Health Care Education/Training Program
MT189586
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD429478
PA MEDICAL LICENSE
PA
01
—
MT189586
PA LICENSING DEPARTMENT
PA
Enumeration date
10/26/2006
Last updated
08/14/2015
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