Provider Demographics
NPI:1427043322
Name:KAMONS, MAUREEN WELDON (OD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:WELDON
Last Name:KAMONS
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 1:1201 S BRADDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1275
Mailing Address - Country:US
Mailing Address - Phone:412-731-2020
Mailing Address - Fax:412-731-3542
Practice Address - Street 1:1201 S BRADDOCK AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1275
Practice Address - Country:US
Practice Address - Phone:412-731-2020
Practice Address - Fax:412-731-3542
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000588152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01728499Medicaid
PAT90302Medicare UPIN
PA584834QHXMedicare PIN
PA01728499Medicaid