Provider Demographics
NPI:1275645830
Name:DRUCKER, BARRY LEE (DO)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:LEE
Last Name:DRUCKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5847 FRANCIS LEWIS BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1698
Mailing Address - Country:US
Mailing Address - Phone:718-224-5500
Mailing Address - Fax:718-281-4634
Practice Address - Street 1:5847 FRANCIS LEWIS BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-1698
Practice Address - Country:US
Practice Address - Phone:718-224-5500
Practice Address - Fax:718-281-4634
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113906207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B17633Medicare UPIN
NY52491AMedicare ID - Type Unspecified