Provider Demographics
NPI:1124185822
Name:REISS, MICHELE ANN (RN, PHD, CS)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:ANN
Last Name:REISS
Suffix:
Gender:F
Credentials:RN, PHD, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 MONTRACHET CT
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2952
Mailing Address - Country:US
Mailing Address - Phone:412-784-5590
Mailing Address - Fax:412-784-5274
Practice Address - Street 1:200 DELAFIELD RD
Practice Address - Street 2:SUITE 2030
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3205
Practice Address - Country:US
Practice Address - Phone:412-784-5590
Practice Address - Fax:412-784-5274
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN214389L163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARE508718Medicare UPIN