Healthcare Provider Details

I. General information

NPI: 1821094137
Provider Name (Legal Business Name): DAWN E HORNBERGER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 E PENN AVE
WERNERSVILLE PA
19565-1613
US

IV. Provider business mailing address

247 E PENN AVE
WERNERSVILLE PA
19565-1613
US

V. Phone/Fax

Practice location:
  • Phone: 610-678-7202
  • Fax: 610-678-9866
Mailing address:
  • Phone: 610-678-7202
  • Fax: 610-678-9866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000172
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberOEG000172
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: