Provider Demographics
NPI:1407853369
Name:BARBAROSSA, FRANCESCO JOHN (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANCESCO
Middle Name:JOHN
Last Name:BARBAROSSA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1002
Mailing Address - Country:US
Mailing Address - Phone:716-874-2455
Mailing Address - Fax:716-874-5775
Practice Address - Street 1:3750 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1002
Practice Address - Country:US
Practice Address - Phone:716-874-2455
Practice Address - Fax:716-874-5775
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006854152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV01609Medicare UPIN
NYRA4583Medicare PIN