Individual
DR. MARK ISACOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1047 ROBIN RD, FRANKLIN SQUARE, NY 11010-1729
(516) 825-2217
Mailing address
1047 ROBIN RD, FRANKLIN SQUARE, NY 11010-1729
(516) 825-2217
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
009895
NY
103TS0200X
School Psychologist
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6804070
GHI PROVIDER NUMBER
NY
Enumeration date
12/16/2005
Last updated
08/27/2010
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