Provider Demographics
NPI:1174122709
Name:ISSA, RAYANE (MD)
Entity type:Individual
Prefix:DR
First Name:RAYANE
Middle Name:
Last Name:ISSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1391 MADISON AVE APT 4G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6906
Mailing Address - Country:US
Mailing Address - Phone:929-288-7629
Mailing Address - Fax:
Practice Address - Street 1:1391 MADISON AVE APT 4G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6906
Practice Address - Country:US
Practice Address - Phone:929-288-7629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP1041252085B0100X
NY3143982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging