Provider Demographics
NPI:1386792141
Name:PISZEL, MICHAEL A (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:PISZEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 2ND STREET PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3830
Mailing Address - Country:US
Mailing Address - Phone:215-942-9429
Mailing Address - Fax:215-942-9432
Practice Address - Street 1:44 2ND STREET PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3830
Practice Address - Country:US
Practice Address - Phone:215-942-9429
Practice Address - Fax:215-942-9432
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007235L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1676244OtherHIGHMARK ID#
PWAETNAMedicare UPIN
PA035546Medicare ID - Type Unspecified