MEDICARE: DR. REBECCA VERNA 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	OEG000070	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3533797000	OTHER	PA	KEYSTONE HEALTH PLAN EAST
2	3533797000	OTHER	PA	PERSONAL CHOICE BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821290792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA VERNA O.D.

Provider Business Mailing Address
First Line	:	3300 GRANT AVE STE 21
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-2632
Country	:	US
Telephone Number	:	215-335-9090
Fax Number	:	215-333-5225

Provider Business Practice Location Address
First Line	:	3300 GRANT AVE STE 21
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-2632
Country	:	US
Telephone Number	:	215-335-9090
Fax Number	:	215-333-5225

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

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	03/01/2021

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