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NPI Code Detail

MEDICARE: CAROL S ISHAK MD

MEDICARE: CAROL S ISHAK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician026427CT
2207L00000XAnesthesiology PhysicianMD030695EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710942743
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL S ISHAK MD
Provider Business Mailing Address
First Line : 2100 MACK BLVD FL 4
Second Line :
City : ALLENTOWN
State : PA
Zip : 18103-5622
Country : US
Telephone Number : 484-884-4500
Fax Number :
Provider Business Practice Location Address
First Line : 330 MAIN ST
Second Line :
City : DICKSON CITY
State : PA
Zip : 18519-1691
Country : US
Telephone Number : 484-884-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 02/19/2024

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Directions to “ CAROL S ISHAK MD” Practice Location

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