Individual
GLENN C ISAACSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140
(215) 707-7300
(215) 707-6417
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3663
(215) 707-6417
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD030568E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011396520001
—
PA
Enumeration date
10/13/2005
Last updated
05/21/2018
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