1033372545 NPI number — MRS. ROSE L MUNROE DO

Table of content: MRS. ROSE L MUNROE DO (NPI 1033372545)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033372545 NPI number — MRS. ROSE L MUNROE DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUNROE
Provider First Name:
ROSE
Provider Middle Name:
L
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KANG
Provider Other First Name:
ROSE
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033372545
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/26/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
119 VIP DR STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEXFORD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15090-7976
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-935-2610
Provider Business Mailing Address Fax Number:
724-935-0331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 BROAD ST STE 422
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEWICKLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15143-1652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-741-8700
Provider Business Practice Location Address Fax Number:
412-741-3710
Provider Enumeration Date:
07/03/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  2008016197 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 005984 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: OS018898 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)