Healthcare Provider Details

I. General information

NPI: 1871201608
Provider Name (Legal Business Name): INDRANANDA ISHAYA MS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 NEW BRITAIN ROAD BUILDING 100 / SUITE 102
DOYLESTOWN PA
18901-2992
US

IV. Provider business mailing address

1834 7TH ST
BETHLEHEM PA
18020-5708
US

V. Phone/Fax

Practice location:
  • Phone: 215-692-2438
  • Fax:
Mailing address:
  • Phone: 828-206-5758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC011436
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberAJ011365
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: