Provider Demographics
NPI:1619976727
Name:ZELESNICK, BARRY S (OD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:S
Last Name:ZELESNICK
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 1:120 N STEPHEN PL
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1937
Mailing Address - Country:US
Mailing Address - Phone:717-632-7727
Mailing Address - Fax:717-632-8745
Practice Address - Street 1:120 N STEPHEN PL
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1937
Practice Address - Country:US
Practice Address - Phone:717-632-7727
Practice Address - Fax:717-632-8745
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000159152WC0802X
MDTA0619152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA234652OtherKEYSTONE
MDXY27OtherCAREFIRST BC/BS
PA0000044146OtherINDEPENDENCE BLUE CROSS
PA50004206OtherCAPITAL BLUE CROSS
PA77478OtherHEALTH AMERICA
PA4490TOtherVSP/VBA
PA410036502OtherRAILROAD
PA044146OtherHIGHMARK BLUE SHIELD
PA284539OtherMAMSI/ALLIANCE
PA504169OtherAETNA/US HEALTHCARE
PA50004206OtherCAPITAL BLUE CROSS
PA0000044146OtherINDEPENDENCE BLUE CROSS
PA4490TOtherVSP/VBA