Basic Information
| Provider Information | |||||||||
| NPI: | 1518089085 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAMINSKI | ||||||||
| FirstName: | MONINA | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20578 W HOLT DR | ||||||||
| Address2: | |||||||||
| City: | BUCKEYE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853967609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6234667501 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7575 W LOWER BUCKEYE RD | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850433450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239075952 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1315 | AZ | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.