| Doctor Name: | MR. ITZHAK MEDAN |
| NPI Number: | 1346485745 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 231274-1 |
| Business Practice Address: | 151 Carol Ln Richboro, PA - 189541307 |
| Business Phone Number: | 4436762585 |
| Business Fax Number: | |
| Mailing Address: | 505 Nostrand Ave, BROOKLYN |
| State: | NY |
| Postal Code: | 112162015 |
| Phone Number: | 7186224444 |
| Fax Number: | |
| NPI Enumeration Date: | 12/13/2008 |
| NPI Last Update Date: | 10/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 231274-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |