Provider Demographics
NPI:1306925789
Name:ISELE, FRANK WILLIAM (PHD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:WILLIAM
Last Name:ISELE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 GLEN STREET
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-2926
Mailing Address - Country:US
Mailing Address - Phone:518-792-1410
Mailing Address - Fax:518-792-0514
Practice Address - Street 1:478 GLEN STREET
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-2926
Practice Address - Country:US
Practice Address - Phone:518-792-1410
Practice Address - Fax:518-792-0514
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004220103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000490450001OtherBLUE SHIELD
NYV44411OtherBLUE CROSS
NY000490450001OtherBLUE SHIELD