Provider Demographics
NPI:1619966546
Name:ISAAC, NISHA (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:NISHA
Middle Name:
Last Name:ISAAC
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6307 DRY STONE GATE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2888
Mailing Address - Country:US
Mailing Address - Phone:410-368-2621
Mailing Address - Fax:410-368-3563
Practice Address - Street 1:900 CATON AVE
Practice Address - Street 2:MAILBOX 068
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5201
Practice Address - Country:US
Practice Address - Phone:410-368-2621
Practice Address - Fax:410-368-3563
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS