Provider Demographics
NPI:1649834789
Name:AL-AMIN, ISA (PRACTICAL NURSE)
Entity type:Individual
Prefix:
First Name:ISA
Middle Name:
Last Name:AL-AMIN
Suffix:
Gender:M
Credentials:PRACTICAL NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S BRADDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1264
Mailing Address - Country:US
Mailing Address - Phone:412-683-7100
Mailing Address - Fax:412-683-4160
Practice Address - Street 1:1400 S BRADDOCK AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1264
Practice Address - Country:US
Practice Address - Phone:412-683-7100
Practice Address - Fax:412-683-4160
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN290142164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse