Healthcare Provider Details

I. General information

NPI: 1134120264
Provider Name (Legal Business Name): FRANK X STANISH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 COAL VALLEY RD SUITE 461
JEFFERSON HILLS PA
15025-3730
US

IV. Provider business mailing address

575 COAL VALLEY RD SUITE 461
JEFFERSON HILLS PA
15025-3730
US

V. Phone/Fax

Practice location:
  • Phone: 412-466-6800
  • Fax: 412-466-8534
Mailing address:
  • Phone: 412-466-6800
  • Fax: 412-466-8534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD030653L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: