Individual
DR. BARRY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
548 BROADWAY, BAYONNE, NJ 07002
(201) 339-4375
(201) 339-0105
Mailing address
548 BROADWAY, BAYONNE, NJ 07002-3864
(201) 339-4375
(201) 339-0105
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
U10238
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112584558
EMPLOYER ID
NY
05
—
7448201
—
NJ
Enumeration date
09/06/2006
Last updated
11/12/2019
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