DR. MARY ISKAROUS (NPI# 1457865131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457865131 |
| Entity Type | Individual |
| Full Name | DR. MARY ISKAROUS |
| Credential | PSY.D. |
| Practice Address |
633d Medical Group 77 Nealy Avenue Joint Base Langley-eustis VA 23665-2040 |
| Practice Telephone | 7577646840 |
| Mailing Telephone | 7577646840 |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810004931 | VA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4601 Ironbound Rd, Williamsburg, VA 231882648 | 4089308134 |
| Street Address |
633D MEDICAL GROUP 77 NEALY AVENUE |
| City | JOINT BASE LANGLEY-EUSTIS |
| State | VA |
| Zip Code | 23665-2040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881688877 | James F Forrest | Optometrist | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2005-09-06 |
| 1497213573 | Diana Elise Strain | Social Worker | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2019-03-07 |
| 1295112977 | Nicholas William Deangelis | Pediatrics | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2015-04-30 |
| 1366839961 | Brent Sager | Obstetrics & Gynecology | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2015-04-21 |
| 1326459652 | Keith Duron | Dental Hygienist | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2014-05-08 |
| 1578998522 | Kristen Ashley Block | Physician Assistant | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2013-09-10 |
| 1336486992 | William F Wolfe | Nurse Anesthetist, Certified Registered | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2013-01-15 |
| 1659638575 | Adam Labree Bourgon | Surgery | 633d Medical Group, 77 Nealy Ave, Joint Base Langley-eustis, VA 23665-2040 | 2012-04-17 |
| 1003101551 | Richard Zanetti Jr. | Pediatrics | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2011-06-13 |
| 1629398565 | Jeffrey Roger Herchler | Physician Assistant | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2010-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228938 | Mai Stern | Student in an Organized Health Care Education/Training Program | Langley Afb Dental Clinic, Hampton, VA 23665 | 2020-06-05 |
| 1386273449 | Nicholas Thomas Nelson | Military Health Care Provider | 633d Medical Group, 76 Nealy Ave, Building #92, Apo, AA 23665 | 2020-04-02 |
| 1316574809 | Kimberly C Easterling | Student in an Organized Health Care Education/Training Program | 76 Nealy Avenue, Joint Base Langley-eustis, Hampton, VA 23665 | 2020-03-24 |
| 1851950026 | Erin Leigh Baldridge | Dentist | Joint Base Langley Eustis Dental Clinic, 76 Nealy Ave, Apo, AA 23665 | 2019-06-11 |
| 1669950739 | Anthony Interrante IIi | Nurse Practitioner | Usaf Hospital Langley, 77 Nealy Avenue, Hampton, VA 23665 | 2018-08-01 |
| 1588189310 | Stacey Marie Jackson | Psychologist | 11 Nealy Blvd, Hampton, VA 23665 | 2017-08-14 |
| 1285062216 | Michael John Vietti | Physician Assistant | 633 Mdg 77 Nealy Ave, Yorktown, VA 23665 | 2013-10-30 |
| 1396182234 | Micaela Jane Dagucon | General Practice | 633d Mdg/sghc, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665 | 2013-06-02 |
| 1912212051 | Michele Leigh Shirley | Pharmacist | 633d Medical Group Hospital, 77 Nealy Avenue, Building 257, Joint Base Langley-eustis, VA 23665 | 2010-08-13 |
| 1497915219 | Stephen Warren Porter | Dentist | 76 Nealy Ave, 1st Dental Squadron/sgd, Langley Air Force Base, VA 23665 | 2008-06-16 |
| Find all providers in zip 23665 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710593603 | Tina Tehrani Nawaz | Psychologist | 23909 Heather Meadow Dr, Ashburn, VA 20148-1767 | 2020-09-16 |
| 1942813720 | David Rothman | Psychologist | 2000 Wilkes Drive, Richomd, VA 23233 | 2020-08-31 |
| 1174135917 | Elizabeth Dehart Richardson | Psychologist | 3023 Arrowhead Rd, Rockingham, VA 22801-8682 | 2020-08-22 |
| 1558973131 | Saharay Elizabeth Martinez | Psychologist | 26 Zenith Loop, Newport News, VA 23601-1270 | 2020-08-17 |
| 1881204097 | Maria Elena Burke | Psychologist | 108 Colonels Way, Williamsburg, VA 23185-5105 | 2020-08-03 |
| 1699385013 | Celeste Macdonald Kelly | Psychologist | 250 Wylderose Cmns, Midlothian, VA 23113-6883 | 2020-08-01 |
| 1811515794 | Thomas Craig Foster Jr. | Psychologist | 115 Bulifants Blvd Ste A, Williamsburg, VA 23188-5720 | 2020-07-08 |
| 1225655012 | Drew Taylor Bassett | Psychologist | 1970 Roanoke Blvd # 116b1, Salem, VA 24153-6404 | 2020-06-29 |
| 1851917843 | Nathaniel Andrew | Psychologist | 3112 Honeywood Ln Apt E, Roanoke, VA 24018-8853 | 2020-06-25 |
| 1548886674 | Anita L Boss | Psychologist | 1200 Prince St, Alexandria, VA 22314-2936 | 2020-06-24 |
| Find all providers with the same taxonomy | ||||
| City | JOINT BASE LANGLEY-EUSTIS |
| Zip Code | 23665 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.