Healthcare Provider Details

I. General information

NPI: 1407535941
Provider Name (Legal Business Name): NUR ISAAK PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARE ALLIANCE 1530 ST CLAIR AVE NE
CLEVELAND OH
44114-2004
US

IV. Provider business mailing address

153 CESAR CHAVEZ ST
SAINT PAUL MN
55107-2226
US

V. Phone/Fax

Practice location:
  • Phone: 216-535-9100
  • Fax: 216-535-2626
Mailing address:
  • Phone: 651-602-7500
  • Fax: 651-602-7580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15611
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.009169RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: