Provider Demographics
NPI:1053393801
Name:BARBATO, JOHN DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:BARBATO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PATERSON PLANK RD
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-3707
Mailing Address - Country:US
Mailing Address - Phone:201-864-2965
Mailing Address - Fax:
Practice Address - Street 1:1301 PATERSON PLANK RD
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3707
Practice Address - Country:US
Practice Address - Phone:201-864-2965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA005314152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2962366OtherAETNA MANAGED CARE
NJ6242201Medicaid
NJ1K8624OtherPHS HEALTH NET
NJ5372479OtherAETNA TRADITIONAL
NJ2962366OtherAETNA MANAGED CARE
NJU51165Medicare UPIN