Provider Demographics
NPI:1578690814
Name:AMONI, SAMUEL S (MD)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:S
Last Name:AMONI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:741 NORTH CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666
Mailing Address - Country:US
Mailing Address - Phone:724-547-9810
Mailing Address - Fax:724-547-9824
Practice Address - Street 1:929 WOOD STREET
Practice Address - Street 2:
Practice Address - City:WILKINSBURG
Practice Address - State:PA
Practice Address - Zip Code:15221
Practice Address - Country:US
Practice Address - Phone:412-731-9888
Practice Address - Fax:412-731-9846
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD013623E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01947421Medicaid
PA01947421Medicaid
PA070068Medicare ID - Type Unspecified