Provider Demographics
NPI:1134756307
Name:BROBST, BARRY WILLIAM
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:WILLIAM
Last Name:BROBST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 E ELIZABETH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6506
Mailing Address - Country:US
Mailing Address - Phone:610-428-6995
Mailing Address - Fax:610-868-0612
Practice Address - Street 1:65 E ELIZABETH AVE STE 300
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6506
Practice Address - Country:US
Practice Address - Phone:610-428-6995
Practice Address - Fax:610-868-0612
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician