Individual
DR. JEFFREY DAVID BARUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
647 HOWARD AVE, WEST HEMPSTEAD, NY 11552-3505
(718) 362-1405
(516) 565-6272
Mailing address
612 CORPORATE WAY STE 2M, VALLEY COTTAGE, NY 10989-2027
(718) 362-1405
(718) 414-1651
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
TUV004881
NY
152W00000X
Optometrist
Primary
TUVOO4881-1
NY
152WC0802X
Corneal and Contact Management Optometrist
TUV004881
NY
152WL0500X
Low Vision Rehabilitation Optometrist
TUV004881
NY
152WP0200X
Pediatric Optometrist
TUV004881
NY
152WX0102X
Occupational Vision Optometrist
TUV004881
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01147864
—
NY
Enumeration date
06/08/2006
Last updated
07/07/2023
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