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Individual

MARILYN K. BERKELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000787
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102035975-0001
PA
01
25-1548092
VISION BENEFITS OF AMERIC
PA
01
5266203
AETNA
PA
Enumeration date
04/17/2006
Last updated
09/23/2008
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