Healthcare Provider Details

I. General information

NPI: 1124289632
Provider Name (Legal Business Name): GERARD PATRICK BARRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 ALBANY SHAKER RD SUITE 101
LATHAM NY
12110
US

IV. Provider business mailing address

920 ALBANY SHAKER RD SUITE 101
LATHAM NY
12110
US

V. Phone/Fax

Practice location:
  • Phone: 518-533-6502
  • Fax: 518-533-6505
Mailing address:
  • Phone: 518-533-6502
  • Fax: 518-533-6505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number246731
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician
License Number246731
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: