Provider Demographics
NPI:1871201608
Name:ISHAYA, INDRANANDA (MS DC)
Entity type:Individual
Prefix:DR
First Name:INDRANANDA
Middle Name:
Last Name:ISHAYA
Suffix:
Gender:M
Credentials:MS DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1834 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-5708
Mailing Address - Country:US
Mailing Address - Phone:828-206-5758
Mailing Address - Fax:
Practice Address - Street 1:701 W BROAD ST
Practice Address - Street 2:SUITE #211 2ND FLOOR
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5248
Practice Address - Country:US
Practice Address - Phone:484-893-0866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAJ011365111NR0400X
PADC011436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation