Provider Demographics
NPI:1699752907
Name:BARARI, ZHALEH (OD)
Entity type:Individual
Prefix:DR
First Name:ZHALEH
Middle Name:
Last Name:BARARI
Suffix:
Gender:F
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:W194 N 16747 EAGLE DR.
Mailing Address - Street 2:SUITE N
Mailing Address - City:JACKSON
Mailing Address - State:WI
Mailing Address - Zip Code:53037
Mailing Address - Country:US
Mailing Address - Phone:262-677-4313
Mailing Address - Fax:262-677-4396
Practice Address - Street 1:W194 N 16747 EAGLE DR.
Practice Address - Street 2:SUITE N
Practice Address - City:JACKSON
Practice Address - State:WI
Practice Address - Zip Code:53037
Practice Address - Country:US
Practice Address - Phone:262-677-4313
Practice Address - Fax:262-677-4396
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2864-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI473210002Medicare PIN