Provider Demographics
NPI:1447634217
Name:ISHIZUKA, MAKI (MD)
Entity type:Individual
Prefix:
First Name:MAKI
Middle Name:
Last Name:ISHIZUKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7210 41ST AVE
Mailing Address - Street 2:APT6J
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3056
Mailing Address - Country:US
Mailing Address - Phone:267-670-1002
Mailing Address - Fax:
Practice Address - Street 1:KY CHILDREN'S HOSPITAL 800 ROSE ST 4TH FL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-3056
Practice Address - Country:US
Practice Address - Phone:859-218-0921
Practice Address - Fax:859-257-1831
Is Sole Proprietor?:No
Enumeration Date:2015-07-12
Last Update Date:2024-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY599822080P0203X
KYTP2942080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine