Provider Demographics
NPI:1912128208
Name:PISCIOTTANO, MAURICE A (DC)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:A
Last Name:PISCIOTTANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 WASHINGTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3065
Mailing Address - Country:US
Mailing Address - Phone:724-942-4444
Mailing Address - Fax:
Practice Address - Street 1:3380 WASHINGTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3065
Practice Address - Country:US
Practice Address - Phone:724-942-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-004185-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU01488Medicare UPIN