MEDICARE: DR. INDRANANDA ISHAYA MS DC

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
1	111N00000X	Chiropractor	DC011436	PA
2	111NR0400X	Rehabilitation Chiropractor	AJ011365	PA

General Provider Information

NPI Number	:	1871201608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. INDRANANDA ISHAYA MS DC

Provider Business Mailing Address
First Line	:	1834 7TH ST
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18020-5708
Country	:	US
Telephone Number	:	828-206-5758
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 NEW BRITAIN ROAD
Second Line	:	BUILDING 100 / SUITE 102
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-2992
Country	:	US
Telephone Number	:	215-692-2438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2022
Last Update Date	:	06/04/2026

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