Healthcare Provider Details

I. General information

NPI: 1568146603
Provider Name (Legal Business Name): MICHAEL RODIA MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 SHAW AVE
MCKEESPORT PA
15132-2918
US

IV. Provider business mailing address

1717 PENN AVE APT 317
WILKINSBURG PA
15221-2655
US

V. Phone/Fax

Practice location:
  • Phone: 412-346-9944
  • Fax:
Mailing address:
  • Phone: 215-776-4124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: