Healthcare Provider Details

I. General information

NPI: 1144498395
Provider Name (Legal Business Name): DR. KAY E. BERNER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 SUNBURY ST
MINERSVILLE PA
17954-1239
US

IV. Provider business mailing address

329 SUNBURY ST
MINERSVILLE PA
17954-1239
US

V. Phone/Fax

Practice location:
  • Phone: 570-544-4792
  • Fax: 570-544-3509
Mailing address:
  • Phone: 570-544-4792
  • Fax: 570-544-3509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. KAY ELAINE BERNER
Title or Position: OWNER
Credential:
Phone: 570-544-4792