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Izik Yitzhaki

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NPI Number Detailed Information

Provider Information:

Name: Izik Yitzhaki
Gender: M
Provider License Number If Given: MA 69133

NPI Information:

NPI: 1902809957
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: PO BOX 343
Midland Park, NJ 07432
Phone Number: 2018042800
Fax Number:

Provider Business Practice Location Address:

Address: 350 BOULEVARD
Passaic, NJ 07055
Phone Number: 9733654300
Fax Number:

Provider Taxonomy:

Primary: 174400000X
Secondary (if any):
State: NJ