Provider Demographics
NPI:1811182470
Name:BARAK, ORR G (MD)
Entity type:Individual
Prefix:
First Name:ORR
Middle Name:G
Last Name:BARAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 WINDMILL RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-1680
Mailing Address - Country:US
Mailing Address - Phone:610-288-2908
Mailing Address - Fax:610-898-4832
Practice Address - Street 1:2913 WINDMILL RD
Practice Address - Street 2:SUITE 7
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1680
Practice Address - Country:US
Practice Address - Phone:610-288-2908
Practice Address - Fax:610-898-4832
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233984207N00000X
PAMD441509207N00000X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA209382ZPA2Medicare PIN
PA209382YG9CMedicare PIN