Mikita, Michael

Mikita, Michael is an individual health care provider with primary practice located at 2 Farm Colony Dr , Warren PA 16365-5203. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mikita, Michael can be contacted via phone (716) 484-6700.

Contact Information

Primary practice address
2 Farm Colony Dr Warren PA 16365-5203
Phone: (716) 484-6700
Fax: (716) 664-7275
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 023972 New York

Profile Details

NPI number 1902454804
LBN Legal business name Mikita, Michael
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 4th, 2019
Last updated Apr 19th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902454804 NPPES
Pennsylvania MEDICAID 103775178
Pennsylvania MEDICAID 06005494

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