Healthcare Provider Details

I. General information

NPI: 1497802029
Provider Name (Legal Business Name): IRENE TSIRONIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 LINCOLN WAY
MCKEESPORT PA
15131-1719
US

IV. Provider business mailing address

2602 DOGWOOD CT
WEXFORD PA
15090-7700
US

V. Phone/Fax

Practice location:
  • Phone: 412-672-3383
  • Fax: 724-935-7156
Mailing address:
  • Phone: 724-934-2014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD040193E
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier0010538130002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: