Provider Demographics
NPI:1437651809
Name:ISIP, ALLAN V (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:V
Last Name:ISIP
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:878 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1713
Mailing Address - Country:US
Mailing Address - Phone:551-265-5936
Mailing Address - Fax:
Practice Address - Street 1:878 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1713
Practice Address - Country:US
Practice Address - Phone:551-265-5936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01777300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist