Individual provider Active NPI

Deborah Ishaal, PA

  • Physician Assistant
  • Great Neck, NY
National Provider Identifier
1033435003
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013792 Issued in NY
Practice address
1010 Northern Blvd
Suite 208
Great Neck, NY 11021-5317
Phone
(718) 888-1467
Fax
(516) 869-8653
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013792 NY Primary

Addresses

Primary practice location

1010 Northern Blvd
Suite 208
Great Neck, NY 11021-5317

Mailing address

444 Middle Neck Road
Apt 3K
Great Neck, NY 11023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013792NYMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: deborah.ishaal@ghuc.eclinicaldirectplus.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1033435003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MIDDLE NECK ROAD",
            "address_2": "APT 3K",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 NORTHERN BLVD",
            "address_2": "SUITE 208",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215317",
            "telephone_number": "718-888-1467",
            "fax_number": "516-869-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHAAL",
        "first_name": "DEBORAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.