Basic Information
| Provider Information | |||||||||
| NPI: | 1104041508 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARCZAK | ||||||||
| FirstName: | MONIKA | ||||||||
| MiddleName: | AGNIESZKA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1761 MOYNELLE DR | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152431635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128051676 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4007 WASHINGTON RD | ||||||||
| Address2: | DONALDSON'S CROSSROADS | ||||||||
| City: | MCMURRAY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153172520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249415100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152WC0802X | OEG001269 | PA | Y | Eye and Vision Services Providers | Optometrist | Corneal and Contact Management |
No ID Information.