Individual
DR. BARBARA ANN GORDEUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
04955
NJ
152W00000X
Optometrist
Primary
0E006881T
PA
152W00000X
Optometrist
T0325
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01851714
—
PA
01
—
0192730000
INDEPENDENCE BLUE CROSS
—
01
—
53028
DAVIS
—
01
—
57599
AETNA
—
01
—
6881
EYMED
PA
Enumeration date
07/13/2006
Last updated
07/30/2013
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