Provider Demographics
NPI:1346359288
Name:MOSKOWITZ, BARRY DAVID (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:DAVID
Last Name:MOSKOWITZ
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 1:1533 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:WHITE OAK
Mailing Address - State:PA
Mailing Address - Zip Code:15131-1711
Mailing Address - Country:US
Mailing Address - Phone:412-672-9765
Mailing Address - Fax:412-672-6902
Practice Address - Street 1:1533 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131-1711
Practice Address - Country:US
Practice Address - Phone:412-672-9765
Practice Address - Fax:412-672-6902
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015109E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009485310002Medicaid
PA0009485310002Medicaid
M026383Medicare ID - Type Unspecified