Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DS038767 | PA |
NPI | 1073870416 |
---|---|
Provider Name | Dr. Erin Michal Issac |
First Address | Pittsburgh, PA 15232-1795 |
Second Address | Pittsburgh, PA 15232-1795 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2012 |
Last Update Date | 22/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1028147270001 | (05) | PA |