Provider Demographics
NPI:1891354312
Name:MAGNER, ANGELIKA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANGELIKA
Middle Name:
Last Name:MAGNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ANGELIKA
Other - Middle Name:
Other - Last Name:BEKERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:23 WILTSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3644
Mailing Address - Country:US
Mailing Address - Phone:917-568-1821
Mailing Address - Fax:
Practice Address - Street 1:37 COULTER AVE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2412
Practice Address - Country:US
Practice Address - Phone:610-726-9010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-08
Last Update Date:2019-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002316152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist