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General NPI Number Information
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NPI Number | 1912104985
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Entity Type | Individual
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Provider Name | JESUS L BARRIOS O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | 221 US HIGHWAY 22
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City | GREEN BROOK
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State | NJ
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Zip | 08812-1921
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Country | US
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Telephone | 732-968-4114
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Fax | 732-968-6966
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Provider Business Mailing Address
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Address Line | 221 US HIGHWAY 22
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City | GREEN BROOK
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State | NJ
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Zip | 08812-1921
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Country | US
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Telephone | 732-968-4114
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Fax | 732-968-6966
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG001902
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00624200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4494
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV007515
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License Number State | NY
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