MEDICARE: ORR G BARAK M.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	207N00000X	Dermatology Physician	233984	MA
2	207N00000X	Dermatology Physician	MD441509	PA
3	207ND0900X	Dermatopathology Physician	MD441509	PA

General Provider Information

NPI Number	:	1811182470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ORR G BARAK M.D.

Provider Business Mailing Address
First Line	:	2913 WINDMILL RD
Second Line	:	SUITE 7
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-1680
Country	:	US
Telephone Number	:	610-288-2908
Fax Number	:	610-898-4832

Provider Business Practice Location Address
First Line	:	2913 WINDMILL RD
Second Line	:	SUITE 7
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-1680
Country	:	US
Telephone Number	:	610-288-2908
Fax Number	:	610-898-4832

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

Provider Enumeration Date	:	09/07/2007
Last Update Date	:	10/05/2015

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