Organization
MON VALLEY DIALYSIS CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBRAMONIAM JAYAKUMAR MD (OWNER, CEO)
(724) 258-9552
Entity
Organization
Contact information
Practice address
1051 COUNTRY CLUB RD, MONONGAHELA, PA 15063-1553
(724) 258-9552
(724) 258-9553
Mailing address
1051 COUNTRY CLUB RD, MONONGAHELA, PA 15063-1553
(724) 258-9552
(724) 258-9553
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD035880L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118094
—
PA
Enumeration date
01/16/2008
Last updated
02/15/2008
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