Provider Demographics
NPI:1972509057
Name:REISS, BARBARA L (OD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:L
Last Name:REISS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 E JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-5614
Mailing Address - Country:US
Mailing Address - Phone:631-462-2020
Mailing Address - Fax:631-462-2227
Practice Address - Street 1:1700 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-5614
Practice Address - Country:US
Practice Address - Phone:631-462-2020
Practice Address - Fax:631-462-2227
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004176152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC47181Medicare ID - Type UnspecifiedMEDICARE ID #
NYU72017Medicare UPIN