Basic Information
| Provider Information | |||||||||
| NPI: | 1053725796 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ISABELLA | ||||||||
| FirstName: | MONICA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 KOLBE RD | ||||||||
| Address2: | |||||||||
| City: | LORAIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440531654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409604522 | ||||||||
| FaxNumber: | 4409604523 | ||||||||
| Practice Location | |||||||||
| Address1: | 3600 KOLBE RD | ||||||||
| Address2: | |||||||||
| City: | LORAIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440531654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409604522 | ||||||||
| FaxNumber: | 4409604523 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2014 | ||||||||
| LastUpdateDate: | 10/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 125065608 | IL | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 35.146421 | OH | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.