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General NPI Number Information
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NPI Number | 1962446690
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Entity Type | Individual
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Provider Name | JONATHAN MARC BAROFSKY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 04/05/2019
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Provider Practice Location Address
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Address Line | 1255 ROUTE 70 STE 31N
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5973
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Country | US
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Telephone | 732-905-0004
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Fax | 732-905-3868
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Provider Business Mailing Address
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Address Line | 1255 ROUTE 70 STE 31N
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5973
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Country | US
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Telephone | 732-920-4700
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Fax | 732-920-6800
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25MA06019900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | MA60199
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License Number State | NJ
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