Provider Demographics
NPI:1467416784
Name:MIKHAIL, MONA RIAD (MD)
Entity Type:Individual
Prefix:MRS
First Name:MONA
Middle Name:RIAD
Last Name:MIKHAIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MONA
Other - Middle Name:RIAD
Other - Last Name:RAFLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:231 LAKEVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:CORAOPALIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108
Mailing Address - Country:US
Mailing Address - Phone:724-222-2010
Mailing Address - Fax:724-222-2509
Practice Address - Street 1:1385 WASHINGTON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301
Practice Address - Country:US
Practice Address - Phone:724-222-2010
Practice Address - Fax:724-222-2509
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053460L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1492789Medicaid
G09347Medicare UPIN
PA555289Medicare ID - Type Unspecified