Provider Demographics
NPI:1235464322
Name:ISAKOVA, INNA (RPA-C)
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:ISAKOVA
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7925 150TH ST APT D6
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3841
Mailing Address - Country:US
Mailing Address - Phone:917-543-0824
Mailing Address - Fax:
Practice Address - Street 1:7925 150TH ST APT D6
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3841
Practice Address - Country:US
Practice Address - Phone:917-543-0824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23 013517363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant