MEDICARE: DR. JOHN DAVID BARBATO O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OA005314	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2962366	OTHER	NJ	AETNA MANAGED CARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1K8624	OTHER	NJ	PHS HEALTH NET
4	5372479	OTHER	NJ	AETNA TRADITIONAL

General Provider Information

NPI Number	:	1053393801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN DAVID BARBATO O.D.

Provider Business Mailing Address
First Line	:	1301 PATERSON PLANK RD
Second Line	:
City	:	SECAUCUS
State	:	NJ
Zip	:	07094-3707
Country	:	US
Telephone Number	:	201-864-2965
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 PATERSON PLANK RD
Second Line	:
City	:	SECAUCUS
State	:	NJ
Zip	:	07094-3707
Country	:	US
Telephone Number	:	201-864-2965
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. JOHN DAVID BARBATO O.D.” Practice Location

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