Provider Demographics
NPI:1396978060
Name:ISAMAN, CHRISTINA A (OD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
Last Name:ISAMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:A
Other - Last Name:GANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3975 CASCADES BLVD STE 18
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-8053
Mailing Address - Country:US
Mailing Address - Phone:330-552-5000
Mailing Address - Fax:330-552-5001
Practice Address - Street 1:3975 CASCADES BLVD
Practice Address - Street 2:SUITE 18
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-8053
Practice Address - Country:US
Practice Address - Phone:330-552-5000
Practice Address - Fax:330-552-5001
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.5940T2855152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MG2138673OtherDEA