Provider Demographics
NPI:1396439683
Name:PORCHIA, ELIANA
Entity type:Individual
Prefix:
First Name:ELIANA
Middle Name:
Last Name:PORCHIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:MI
Mailing Address - Zip Code:48637-0142
Mailing Address - Country:US
Mailing Address - Phone:989-715-2050
Mailing Address - Fax:989-794-6226
Practice Address - Street 1:22040 GRATIOT RD
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:MI
Practice Address - Zip Code:48637-8707
Practice Address - Country:US
Practice Address - Phone:989-715-2050
Practice Address - Fax:989-794-6226
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI41069-166-791-6930246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy