Individual
DR. BARRY SCHLACTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
124 SMITH HAVEN MALL, LAKE GROVE, NY 11755-1214
(631) 724-9055
(631) 724-9142
Mailing address
124 SMITH HAVEN MALL, LAKE GROVE, NY 11755-1214
(631) 724-9055
(631) 724-9142
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV003919-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2567013
—
NY
Enumeration date
03/29/2007
Last updated
09/12/2014
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