Provider Demographics
NPI:1528070547
Name:ISHIKAWA, ATSUKO (MD)
Entity type:Individual
Prefix:DR
First Name:ATSUKO
Middle Name:
Last Name:ISHIKAWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ATSUKO
Other - Middle Name:
Other - Last Name:ISHIKAWA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:15 W 44TH ST FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-6611
Mailing Address - Country:US
Mailing Address - Phone:212-575-8910
Mailing Address - Fax:212-575-1830
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-273-6062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN616792084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry