Provider Demographics
NPI:1417535758
Name:ALLOZI, ISAAC
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:ALLOZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 S 25TH ST APT 18
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6477
Mailing Address - Country:US
Mailing Address - Phone:701-885-1387
Mailing Address - Fax:
Practice Address - Street 1:2700 S 25TH ST APT 18
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6477
Practice Address - Country:US
Practice Address - Phone:701-885-1387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
ND14674483747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant