| Farra Isaacson, Dds Pllc | |
|
1150 Portion Rd Suite 15 Holtsville NY 11742-1074 | |
| (631) 696-3820 | |
| (631) 696-7780 |
| Full Name | Farra Isaacson, Dds Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1150 Portion Rd, Holtsville, New York |
| Authorized Official Name and Position | Farra Isaacson (ONWER/DENTIST) |
| Authorized Official Contact | 6316963820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Farra Isaacson, Dds Pllc 1150 Portion Rd Suite 15 Holtsville NY 11742-1074 Ph: (631) 696-3820 | Farra Isaacson, Dds Pllc 1150 Portion Rd Suite 15 Holtsville NY 11742-1074 Ph: (631) 696-3820 |
| NPI Number | 1891227682 |
|---|---|
| Provider Enumeration Date | 03/30/2017 |
| Last Update Date | 03/30/2017 |
| Medicare PECOS PAC ID | 6608119789 |
|---|---|
| Medicare Enrollment ID | O20190513000034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891227682 | NPI | - | NPPES |
| 02249296 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 049280 (New York) | Primary |
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