MEDICARE: MR. ADAM JOSEPH DILLNER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG002956	PA

General Provider Information

NPI Number	:	1407261225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ADAM JOSEPH DILLNER O.D.

Provider Business Mailing Address
First Line	:	673 CASTLE CREEK DRIVE EXT
Second Line	:	SUITE 104
City	:	SEVEN FIELDS
State	:	PA
Zip	:	16046-7864
Country	:	US
Telephone Number	:	724-778-3937
Fax Number	:	724-778-3946

Provider Business Practice Location Address
First Line	:	673 CASTLE CREEK DRIVE EXT
Second Line	:	SUITE 104
City	:	SEVEN FIELDS
State	:	PA
Zip	:	16046-7864
Country	:	US
Telephone Number	:	724-778-3937
Fax Number	:	724-778-3946

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2014
Last Update Date	:	07/01/2014

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