Provider Demographics
NPI:1386654549
Name:SAGGAR, MONA S (OD)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:S
Last Name:SAGGAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 CEI DR
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5664
Mailing Address - Country:US
Mailing Address - Phone:513-569-3741
Mailing Address - Fax:513-569-3941
Practice Address - Street 1:7527 STATE RD
Practice Address - Street 2:SUITE A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-6407
Practice Address - Country:US
Practice Address - Phone:513-232-5550
Practice Address - Fax:513-232-3510
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4588152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2650073Medicaid
OH0777093Medicare PIN
U54165Medicare UPIN
OH0777091Medicare PIN