1659576429 NPI number — MISS MICHELLE LARISSA FINET PA

Table of content: MISS MICHELLE LARISSA FINET PA (NPI 1659576429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659576429 NPI number — MISS MICHELLE LARISSA FINET PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINET
Provider First Name:
MICHELLE
Provider Middle Name:
LARISSA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659576429
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 WATER WHEEL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAMPION
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15622-4007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-708-2891
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6396 PA-819
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT. PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
878-285-2035
Provider Business Practice Location Address Fax Number:
878-285-2036
Provider Enumeration Date:
06/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  MA053001 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MA053001 . This is a "STATE PA LICENSE #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 116369300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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