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General NPI Number Information
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NPI Number | 1205396918
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Entity Type | Individual
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Provider Name | MARK PIETRO SERALY MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE STE 3200
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-249-6176
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Fax |
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Provider Business Mailing Address
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Address Line | 11100 EUCLID AVE STE 3200
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 724-263-5431
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35.148463
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 35.148463
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License Number State | OH
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