Individual
JAKE ABRAHAM ISAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(215) 612-4132
Mailing address
9 ANTONIO CT, ENDICOTT, NY 13760-6531
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA065111
PA
Other
Enumeration date
08/25/2023
Last updated
10/27/2023
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