Healthcare Provider Details

I. General information

NPI: 1720782535
Provider Name (Legal Business Name): TAMIKA TAYLOR ISAAC DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 CONCORD AVE STE 6100
CAMBRIDGE MA
02138-1040
US

IV. Provider business mailing address

330 MOUNT AUBURN ST PARSONS 2
CAMBRIDGE MA
02138-5597
US

V. Phone/Fax

Practice location:
  • Phone: 617-864-8822
  • Fax: 617-547-5367
Mailing address:
  • Phone: 617-864-8822
  • Fax: 617-547-5367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1025694
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: