Provider Demographics
NPI:1285738526
Name:ISAKOV, OLEG (MD)
Entity type:Individual
Prefix:DR
First Name:OLEG
Middle Name:
Last Name:ISAKOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:98120 QUEENS BLVD APT 10
Mailing Address - Street 2:A COMPREHENSICE COUNSELING CTR LLC
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4357
Mailing Address - Country:US
Mailing Address - Phone:718-830-0246
Mailing Address - Fax:718-830-9088
Practice Address - Street 1:98120 QUEENS BLVD APT 10
Practice Address - Street 2:A COMPREHENSICE COUNSELING CTR LLC
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4357
Practice Address - Country:US
Practice Address - Phone:718-830-0246
Practice Address - Fax:718-830-9088
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2370622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
P3641107OtherOXFORD
7351772OtherGHI
P3641107OtherOXFORD
144932Medicare UPIN