MEDICARE: BARENBURG OPTICAL SERVICE, INC

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

General Provider Information

NPI Number	:	1225876238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARENBURG OPTICAL SERVICE, INC

Provider Business Mailing Address
First Line	:	100 PARK AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-3416
Country	:	US
Telephone Number	:	410-752-1677
Fax Number	:

Provider Business Practice Location Address
First Line	:	1003 N POINT BLVD STE 605
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21224-3662
Country	:	US
Telephone Number	:	410-282-5544
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	KATHRYN MARANTO
Credential	:
Telephone Number	:	410-752-1677

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	07/16/2024

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Directions to “BARENBURG OPTICAL SERVICE, INC ” Practice Location

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