Provider Demographics
NPI:1700913258
Name:BARKER, BARRY M (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:M
Last Name:BARKER
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 FERNBROOK AVENUE
Mailing Address - Street 2:
Mailing Address - City:OAKFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19053-3505
Mailing Address - Country:US
Mailing Address - Phone:215-355-8446
Mailing Address - Fax:
Practice Address - Street 1:1905 FERNBROOK AVENUE
Practice Address - Street 2:A 1 OPTICAL
Practice Address - City:OAKFORD
Practice Address - State:PA
Practice Address - Zip Code:19053-3505
Practice Address - Country:US
Practice Address - Phone:215-355-8446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAA282869OtherCLARITY VISION
PA393553OtherNVA