Provider Demographics
NPI:1871637959
Name:MIROYA J. MONSOUR
Entity Type:Organization
Organization Name:MIROYA J. MONSOUR
Other - Org Name:DBA MIROYA J. MONSOUR/CENTER FOR SIGHT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPHTHALMOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:MIROYA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MONSOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-744-4009
Mailing Address - Street 1:1075 HARRISON CITY-EXPORT RD
Mailing Address - Street 2:STE. 1
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644
Mailing Address - Country:US
Mailing Address - Phone:724-744-4009
Mailing Address - Fax:724-744-2065
Practice Address - Street 1:1075 HARRISON CITY-EXPORT RD
Practice Address - Street 2:STE. 1
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644
Practice Address - Country:US
Practice Address - Phone:724-744-4009
Practice Address - Fax:724-744-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013906530005Medicaid
PA5036640001OtherMEDICARE PTAN
PA0013906530005Medicaid
PAM038442Medicare PIN