Provider Demographics
NPI:1992749386
Name:MONDZELEWSKI, JAMES P (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:MONDZELEWSKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1145 BOWER HILL RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1342
Mailing Address - Country:US
Mailing Address - Phone:412-572-6121
Mailing Address - Fax:412-571-1327
Practice Address - Street 1:1145 BOWER HILL RD
Practice Address - Street 2:SUITE 205
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1342
Practice Address - Country:US
Practice Address - Phone:412-572-6121
Practice Address - Fax:412-571-1327
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2010-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD018438E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000093571OtherUNISON HEALTH PLAN
PA180009454OtherRAILROAD MEDICARE
PA7514OtherHEALTH AMERICA
PA0017383050001Medicaid
PA116161OtherAETNA
PA1373927OtherUNITED MINE WORKERS
PA180009454OtherRAILROAD MEDICARE
PAB31274Medicare UPIN