MEDICARE: DR. BARBARA VAN OD

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	2771	NC

General Provider Information

NPI Number	:	1942819289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA VAN OD

Provider Business Mailing Address
First Line	:	5 DAKOTA DR STE 307
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1106
Country	:	US
Telephone Number	:	877-506-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	7905 LYLES LN NW
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28027-7111
Country	:	US
Telephone Number	:	704-979-3900
Fax Number	:

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

Provider Enumeration Date	:	07/22/2020
Last Update Date	:	01/14/2026

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Directions to “ DR. BARBARA VAN OD” Practice Location

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