| Doctor Name: | CAROL ISRAEL MCKISSOCK |
| NPI Number: | 1437195716 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 26NN07841400 |
| Business Practice Address: | 571 Central Ave New Providence, NJ - 079741547 |
| Business Phone Number: | 9084647300 |
| Business Fax Number: | 9084647350 |
| Mailing Address: | 571 Central Ave, NEW PROVIDENCE |
| State: | NJ |
| Postal Code: | 079741547 |
| Phone Number: | 9084647300 |
| Fax Number: | 9084647350 |
| NPI Enumeration Date: | 06/22/2006 |
| NPI Last Update Date: | 02/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 26NN07841400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |