MEDICARE: NICOLETTE CHIESA M.D.

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	207R00000X	Internal Medicine Physician	MD046526L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00248561	OTHER		RAILROAD MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144292640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLETTE CHIESA M.D.

Provider Business Mailing Address
First Line	:	701 TECHNOLOGY DR STE 150
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-9531
Country	:	US
Telephone Number	:	412-531-2902
Fax Number	:	412-531-2948

Provider Business Practice Location Address
First Line	:	1168 WASHINGTON PIKE
Second Line	:
City	:	BRIDGEVILLE
State	:	PA
Zip	:	15017-2828
Country	:	US
Telephone Number	:	412-257-2050
Fax Number	:	412-257-1157

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	07/06/2023

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