Provider Demographics
NPI:1992796395
Name:MCISAAC, JOSEPH HILARY III (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HILARY
Last Name:MCISAAC
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:99 E RIVER DR
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-7301
Mailing Address - Country:US
Mailing Address - Phone:860-282-0833
Mailing Address - Fax:
Practice Address - Street 1:99 E RIVER DR
Practice Address - Street 2:5TH FLOOR
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-3288
Practice Address - Country:US
Practice Address - Phone:860-282-4022
Practice Address - Fax:860-289-0746
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2021-04-17
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Provider Licenses
StateLicense IDTaxonomies
CT029030207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001290303Medicaid
CT001290303Medicaid
E52786Medicare UPIN