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General NPI Number Information
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NPI Number | 1043473903
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Entity Type | Individual
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Provider Name | AMY LYNNE ISHAK APRN
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Gender | Female
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 99 BEAUVOIR AVE
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City | SUMMIT
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State | NJ
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Zip | 07901-3533
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Country | US
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Telephone | 908-522-5310
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Fax |
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Provider Business Mailing Address
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Address Line | 3403 BALSAM WAY
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-3157
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00162600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP10858
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP70011590
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License Number State | WA
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