Provider Demographics
NPI:1841310711
Name:FISCHETTI, CHRISTINE MARIE (PHD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:FISCHETTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 N CRAIG ST
Mailing Address - Street 2:SUITE 215A
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2744
Mailing Address - Country:US
Mailing Address - Phone:412-682-3554
Mailing Address - Fax:
Practice Address - Street 1:128 N CRAIG ST
Practice Address - Street 2:SUITE 215A
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2744
Practice Address - Country:US
Practice Address - Phone:412-682-3554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003625-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAFI174178Medicare ID - Type Unspecified