Provider Demographics
NPI:1770795106
Name:ISAAC, LEA MICHELLE (DO)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:MICHELLE
Last Name:ISAAC
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1098 W BALTIMORE PIKE
Mailing Address - Street 2:HCCII SUITE 2303
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5139
Mailing Address - Country:US
Mailing Address - Phone:610-627-4400
Mailing Address - Fax:610-627-4408
Practice Address - Street 1:1088 W BALTIMORE PIKE
Practice Address - Street 2:HCCII SUITE 2303
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:610-627-4400
Practice Address - Fax:610-627-4408
Is Sole Proprietor?:No
Enumeration Date:2007-05-06
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014390207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA440771OtherMLHC MEDICARE AA
PA134107ZXH5Medicare PIN
PA134107HK1Medicare PIN