Provider Demographics
NPI:1619038577
Name:THE OPTICAL BARR INC.
Entity Type:Organization
Organization Name:THE OPTICAL BARR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SECORD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:607-753-9629
Mailing Address - Street 1:201 MCLEAN RD
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-3509
Mailing Address - Country:US
Mailing Address - Phone:607-753-9629
Mailing Address - Fax:607-753-9454
Practice Address - Street 1:201 MCLEAN RD
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-3509
Practice Address - Country:US
Practice Address - Phone:607-753-9629
Practice Address - Fax:607-753-9454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY2925152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0946720001Medicare NSC
NYAA1054Medicare PIN