Provider Demographics
NPI:1447387667
Name:SERALY, LORETTA G (OD)
Entity type:Individual
Prefix:DR
First Name:LORETTA
Middle Name:G
Last Name:SERALY
Suffix:
Gender:
Credentials:OD
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Mailing Address - Street 1:220 E MCMURRAY RD
Mailing Address - Street 2:STE B
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317
Mailing Address - Country:US
Mailing Address - Phone:724-942-1300
Mailing Address - Fax:724-942-3540
Practice Address - Street 1:220 E MCMURRAY RD
Practice Address - Street 2:STE B
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317
Practice Address - Country:US
Practice Address - Phone:724-942-1300
Practice Address - Fax:724-942-3540
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001740152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA712440ZQRGMedicare PIN