| Dr Mika Ishitani, DC | |
|
1600 Parker Ave, Ste #1, Fort Lee, NJ 07024-7050 | |
| (201) 302-9993 | |
| (201) 302-9994 |
| Full Name | Dr Mika Ishitani |
|---|---|
| Gender | Female |
| Speciality | Chiropractor |
| Location | 1600 Parker Ave, Fort Lee, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710962949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 38MC00633500 (New Jersey) | Primary |
| Provider Name | Lusky Corp |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1407441892 PECOS PAC ID: 1153739107 Enrollment ID: O20210413000914 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mika Ishitani, DC 1600 Parker Ave, Ste #1, Fort Lee, NJ 07024-7050 Ph: (201) 302-9993 | Dr Mika Ishitani, DC 1600 Parker Ave, Ste #1, Fort Lee, NJ 07024-7050 Ph: (201) 302-9993 |
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