Provider Demographics
NPI:1194748533
Name:TSAPOK, ISOLDA (MD)
Entity type:Individual
Prefix:
First Name:ISOLDA
Middle Name:
Last Name:TSAPOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 GLENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5484
Mailing Address - Country:US
Mailing Address - Phone:718-351-1221
Mailing Address - Fax:718-351-2153
Practice Address - Street 1:2076 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3427
Practice Address - Country:US
Practice Address - Phone:718-351-1221
Practice Address - Fax:718-351-2153
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239572174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty