Provider Demographics
NPI:1194182287
Name:ISAEV, DMITRY A (CRNP)
Entity Type:Individual
Prefix:
First Name:DMITRY
Middle Name:A
Last Name:ISAEV
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Gender:M
Credentials:CRNP
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Mailing Address - Street 1:41 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-5522
Mailing Address - Fax:215-710-5181
Practice Address - Street 1:333 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2434
Practice Address - Country:US
Practice Address - Phone:215-728-6900
Practice Address - Fax:215-214-4044
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2021-05-25
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Provider Licenses
StateLicense IDTaxonomies
PASP015788363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology