Provider Demographics
NPI:1447219126
Name:WENDEL, CLAUDIA J (OD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:J
Last Name:WENDEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 ATHENA DR
Mailing Address - Street 2:
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-1005
Mailing Address - Country:US
Mailing Address - Phone:724-468-6869
Mailing Address - Fax:724-468-6207
Practice Address - Street 1:808 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-2228
Practice Address - Country:US
Practice Address - Phone:412-331-9696
Practice Address - Fax:412-331-5540
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000796152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30303Medicare UPIN
PA419659Medicare PIN
PA0768370001Medicare NSC