Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC007235L | PA |
NPI | 1386792141 |
---|---|
Provider Name | Dr. Michael A Piszel |
First Address | Southampton, PA 18966-3830 |
Second Address | Southampton, PA 18966-3830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 25/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1676244 | HIGHMARK ID# (01) | PA |
AETNA | (02) | PW |