Provider Demographics
NPI:1134865793
Name:KEI ACUTE CARE NP SERVICES PC
Entity type:Organization
Organization Name:KEI ACUTE CARE NP SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATTALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-886-1583
Mailing Address - Street 1:6712 YELLOWSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6712 YELLOWSTONE BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2353
Practice Address - Country:US
Practice Address - Phone:347-886-1583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty