MEDICARE: RONALD A. MONACK D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS008970L	PA

General Provider Information

NPI Number	:	1790783140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD A. MONACK D.O.

Provider Business Mailing Address
First Line	:	508 S CHURCH ST STE 100
Second Line	:
City	:	MT PLEASANT
State	:	PA
Zip	:	15666-1702
Country	:	US
Telephone Number	:	724-547-4536
Fax Number	:	724-547-3799

Provider Business Practice Location Address
First Line	:	508 S CHURCH ST STE 100
Second Line	:
City	:	MT PLEASANT
State	:	PA
Zip	:	15666-1702
Country	:	US
Telephone Number	:	724-547-4536
Fax Number	:	724-547-3799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	03/10/2026

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