Individual
IZOLA BERNADETTE DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4148 LANCASTER AVE, PHILADELPHIA, PA 19104-1727
(215) 662-0119
(215) 662-5339
Mailing address
4148 LANCASTER AVE, PHILADELPHIA, PA 19104-1727
(215) 662-0119
(215) 662-5339
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS006306L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001132677
—
PA
01
—
528237E7P
MEDICARE
PA
Enumeration date
01/26/2006
Last updated
01/26/2016
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