Provider Demographics
NPI:1689768210
Name:WENDEKIER, RHONDA ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:ANN
Last Name:WENDEKIER
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 1:304 MAGEE AVE
Mailing Address - Street 2:
Mailing Address - City:PATTON
Mailing Address - State:PA
Mailing Address - Zip Code:16668-1016
Mailing Address - Country:US
Mailing Address - Phone:814-344-2005
Mailing Address - Fax:814-344-8197
Practice Address - Street 1:304 MAGEE AVE
Practice Address - Street 2:
Practice Address - City:PATTON
Practice Address - State:PA
Practice Address - Zip Code:16668-1016
Practice Address - Country:US
Practice Address - Phone:814-344-2005
Practice Address - Fax:814-344-8197
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001650152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011543540002Medicaid
PA1013186485Medicare NSC
PA031188Medicare ID - Type Unspecified
PA1011543540002Medicaid
PA5376780001Medicare NSC