Provider Demographics
NPI:1952287211
Name:ISAKOV, VICTORIA (FNP)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:ISAKOV
Suffix:
Gender:X
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86100 MARENGO ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1437
Mailing Address - Country:US
Mailing Address - Phone:917-822-6400
Mailing Address - Fax:
Practice Address - Street 1:86100 MARENGO ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-1437
Practice Address - Country:US
Practice Address - Phone:917-822-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF357594-01363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner