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General NPI Number Information
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NPI Number | 1861618589
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Entity Type | Organization
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Legal Business Name | JOHN MISSRY, M.D., L.L.C.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 5701 CENTRE AVE SUITE L-3
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City | PITTSBURGH
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State | PA
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Zip | 15206-3744
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Country | US
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Telephone | 412-661-2100
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Fax | 412-661-3930
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Provider Business Mailing Address
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Address Line | 5701 CENTRE AVE SUITE L-3
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City | PITTSBURGH
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State | PA
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Zip | 15206-3744
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Country | US
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Telephone | 412-661-2100
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Fax | 412-661-3930
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN MISSRY
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Credential | M.D.
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Telephone | 412-661-2100
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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 | MD048849L
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License Number State | PA
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