Provider Demographics
NPI:1952400160
Name:DITOMMASO, MICHELE ANN (APRN, BC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:DITOMMASO
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 BOYCE PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239
Mailing Address - Country:US
Mailing Address - Phone:412-795-2133
Mailing Address - Fax:412-688-6907
Practice Address - Street 1:UNIVERSITY DRIVE C
Practice Address - Street 2:CARDIOLOGY, 111C-U
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-688-6183
Practice Address - Fax:412-688-6907
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN224167L364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical