Provider Demographics
NPI:1053456509
Name:SCHANZER, BARRY MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:MARK
Last Name:SCHANZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 OAK TREE RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2704
Mailing Address - Country:US
Mailing Address - Phone:732-548-0700
Mailing Address - Fax:732-494-5059
Practice Address - Street 1:1812 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2704
Practice Address - Country:US
Practice Address - Phone:732-548-0700
Practice Address - Fax:732-494-5059
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA6441700207WX0109X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG35729Medicare UPIN