MEDICARE: MISS MICHELLE LARISSA FINET PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA053001	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA053001	OTHER	PA	STATE PA LICENSE #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659576429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MICHELLE LARISSA FINET PA

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

Provider Business Practice Location Address
First Line	:	575 COAL VALLEY RD STE 374
Second Line	:
City	:	CLAIRTON
State	:	PA
Zip	:	15025-3739
Country	:	US
Telephone Number	:	412-469-7744
Fax Number	:	412-469-7745

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	05/20/2024

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1013566967 — SARAH CHRISTINA HUBER PHYSICIAN ASSISTANT
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1417766445 — KAITLIN MARIE SCHRATZ PA-C
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