Provider Demographics
NPI:1407347800
Name:HORNEDO, EDDIE JR (LDO)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:
Last Name:HORNEDO
Suffix:JR
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2327
Mailing Address - Country:US
Mailing Address - Phone:978-390-0022
Mailing Address - Fax:
Practice Address - Street 1:339 SQUIRE RD
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4309
Practice Address - Country:US
Practice Address - Phone:781-289-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6016156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician