Healthcare Provider Details

I. General information

NPI: 1346639861
Provider Name (Legal Business Name): SERALY EYE CARE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 09/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E MCMURRAY RD
MC MURRAY PA
15317-2948
US

IV. Provider business mailing address

220 E MCMURRAY RD
MC MURRAY PA
15317-2948
US

V. Phone/Fax

Practice location:
  • Phone: 724-942-1300
  • Fax:
Mailing address:
  • Phone: 724-942-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberOEG001740
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LORETTA G SERALY
Title or Position: OWNER/OPTOMETRIST
Credential: O.D.
Phone: 724-942-1300