Provider Demographics
NPI:1467605964
Name:TRYBULSKI, DAWN MARLENE (OD)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARLENE
Last Name:TRYBULSKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARLENE
Other - Last Name:D'ANTONIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:716 N BETHLEHEM PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2656
Mailing Address - Country:US
Mailing Address - Phone:215-237-5337
Mailing Address - Fax:215-501-5070
Practice Address - Street 1:716 N BETHLEHEM PIKE STE 100
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-2656
Practice Address - Country:US
Practice Address - Phone:215-237-5337
Practice Address - Fax:215-501-5070
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002152152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA145009E45Medicare PIN