Provider Demographics
NPI:1649984691
Name:MARLENA MITCHELL-MCCANN
Entity type:Organization
Organization Name:MARLENA MITCHELL-MCCANN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL-MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-413-7572
Mailing Address - Street 1:101 WINDERMERE CT
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3671
Mailing Address - Country:US
Mailing Address - Phone:724-413-7572
Mailing Address - Fax:724-413-7572
Practice Address - Street 1:2200 WASHINGTON PIKE
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-3750
Practice Address - Country:US
Practice Address - Phone:412-429-1689
Practice Address - Fax:412-429-1704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty