Healthcare Provider Details

I. General information

NPI: 1255150637
Provider Name (Legal Business Name): ISOBEL MOYER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2024
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S WAWASET RD
WEST CHESTER PA
19382-6776
US

IV. Provider business mailing address

157 CRICKET AVE APT 5
ARDMORE PA
19003-2117
US

V. Phone/Fax

Practice location:
  • Phone: 610-344-5040
  • Fax:
Mailing address:
  • Phone: 302-943-5137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: