Provider Demographics
NPI:1962446690
Name:BAROFSKY, JONATHAN MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:MARC
Last Name:BAROFSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1255 ROUTE 70
Mailing Address - Street 2:STE 31N
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5973
Mailing Address - Country:US
Mailing Address - Phone:732-920-4700
Mailing Address - Fax:732-920-6800
Practice Address - Street 1:1255 ROUTE 70 STE 31N
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5973
Practice Address - Country:US
Practice Address - Phone:732-905-0004
Practice Address - Fax:732-905-3868
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06019900207W00000X
NJMA60199207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8254800Medicaid