Healthcare Provider Details

I. General information

NPI: 1801455845
Provider Name (Legal Business Name): ISRAA TAHA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 BLAKESLEE BOULEVARD DR E STE 3
LEHIGHTON PA
18235-2401
US

IV. Provider business mailing address

8025 PARKER PL
FOGELSVILLE PA
18051-7702
US

V. Phone/Fax

Practice location:
  • Phone: 570-386-6900
  • Fax:
Mailing address:
  • Phone: 248-224-6569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD478731
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: