Provider Demographics
NPI:1659378248
Name:WASSERMAN, BARRY N (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:N
Last Name:WASSERMAN
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 1:2999 PRINCETON PIKE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648
Mailing Address - Country:US
Mailing Address - Phone:609-243-8711
Mailing Address - Fax:609-243-0199
Practice Address - Street 1:2999 PRINCETON PIKE
Practice Address - Street 2:SUITE 1
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648
Practice Address - Country:US
Practice Address - Phone:609-243-8711
Practice Address - Fax:609-243-0199
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA06022300207W00000X
PAMD062901L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2K1973OtherHEALTH NET
NJ5791562OtherAETNA
NJ1117826OtherHORIZON NJ HEALTH
NJ0399372000OtherINDEPENDENCE B/C
NJ8170801Medicaid
NJ2300970OtherAETNA HMO
NJ407203OtherAMERIHEALTH
NJ2300970OtherAETNA HMO
NJ8170801Medicaid
NJ407203OtherAMERIHEALTH