Provider Demographics
NPI:1861837965
Name:IZAKOV, NATALYA B (DO)
Entity type:Individual
Prefix:DR
First Name:NATALYA
Middle Name:B
Last Name:IZAKOV
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 ROSELAND AVE
Mailing Address - Street 2:UNIT 1104
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5943
Mailing Address - Country:US
Mailing Address - Phone:973-287-6485
Mailing Address - Fax:
Practice Address - Street 1:105 ROSELAND AVE
Practice Address - Street 2:UNIT 1104
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5943
Practice Address - Country:US
Practice Address - Phone:973-287-6485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine