Provider Demographics
NPI:1891898839
Name:ANDREE, BARBARA C (OD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:C
Last Name:ANDREE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:129 N WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3561
Mailing Address - Country:US
Mailing Address - Phone:610-254-9155
Mailing Address - Fax:610-254-0488
Practice Address - Street 1:129 N WAYNE AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3561
Practice Address - Country:US
Practice Address - Phone:610-254-9155
Practice Address - Fax:610-254-0488
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000187152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4581560001Medicare NSC
T30628Medicare UPIN