Provider Demographics
NPI:1093980963
Name:DRAYER, BARRY R (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:R
Last Name:DRAYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 STEWART AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6696
Mailing Address - Country:US
Mailing Address - Phone:516-683-0890
Mailing Address - Fax:516-683-0892
Practice Address - Street 1:1600 STEWART AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6696
Practice Address - Country:US
Practice Address - Phone:516-683-0890
Practice Address - Fax:516-683-0892
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0286241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice