1710044300 NPI number — CYNTHIA A ISEMAN DMD

Table of content: CYNTHIA A ISEMAN DMD (NPI 1710044300)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710044300 NPI number — CYNTHIA A ISEMAN DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ISEMAN
Provider First Name:
CYNTHIA
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710044300
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 GRANT STREET
Provider Second Line Business Mailing Address:
PO BOX 338
Provider Business Mailing Address City Name:
SALISBURY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15558
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-662-2771
Provider Business Mailing Address Fax Number:
814-662-2771

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 GRANT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-662-2771
Provider Business Practice Location Address Fax Number:
814-662-2771
Provider Enumeration Date:
01/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DS030306L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9472000000030306 . This is a "DELTA DENTAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0017775550005 . This is a "MEDICAL ASSISTANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 142397 . This is a "UNISON MED PLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007194469 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0008936 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001427229 . This is a "HIGH MARK BS & UNITED CON" identifier . This identifiers is of the category "OTHER".




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