Provider Demographics
NPI:1194123380
Name:HORNER, AILEEN MARING (OD)
Entity type:Individual
Prefix:DR
First Name:AILEEN
Middle Name:MARING
Last Name:HORNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:AILEEN
Other - Middle Name:MORALES
Other - Last Name:MARING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1201 N MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4356
Mailing Address - Country:US
Mailing Address - Phone:757-942-0452
Mailing Address - Fax:
Practice Address - Street 1:1201 N MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4356
Practice Address - Country:US
Practice Address - Phone:757-942-0452
Practice Address - Fax:757-942-0457
Is Sole Proprietor?:No
Enumeration Date:2014-12-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15165152W00000X
VA0618002545152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist