Basic Information
| Provider Information | |||||||||
| NPI: | 1386792398 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCANNAPIECO | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41 UNIVERSITY DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | NEWTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189401873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157107037 | ||||||||
| FaxNumber: | 2157105181 | ||||||||
| Practice Location | |||||||||
| Address1: | 1205 LANGHORNE NEWTOWN RD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | LANGHORNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190471219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157104480 | ||||||||
| FaxNumber: | 2157104485 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2007 | ||||||||
| LastUpdateDate: | 01/16/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | MD074252L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1412771 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | P012103 | 01 | PA | GATEWAY | OTHER | 1025511250001 | 05 | PA | MEDICAID | P00926827 | 01 | PA | RAILROAD MEDICARE | OTHER | 30097430 | 01 | PA | KEYSTONE FIRST | OTHER | 2099608000 | 01 | PA | KEYSTONE IBC | OTHER | 9521472 | 01 | PA | AETNA | OTHER | 0415441 | 01 | PA | CIGNA PA | OTHER |