Provider Demographics
NPI:1689146227
Name:MONROEVILLE SCIC INC
Entity Type:Organization
Organization Name:MONROEVILLE SCIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISTOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-957-5400
Mailing Address - Street 1:600 LOUIS DR STE 202
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2847
Mailing Address - Country:US
Mailing Address - Phone:215-957-5400
Mailing Address - Fax:
Practice Address - Street 1:2490 MOSSIDE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-4236
Practice Address - Country:US
Practice Address - Phone:215-957-5400
Practice Address - Fax:215-957-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty