Provider Demographics
NPI:1962413609
Name:PREISS, BARRY A (OD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:A
Last Name:PREISS
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 1:8155 E RITCHIE HWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122
Mailing Address - Country:US
Mailing Address - Phone:410-544-4441
Mailing Address - Fax:410-544-4765
Practice Address - Street 1:8155 E RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122
Practice Address - Country:US
Practice Address - Phone:410-544-4441
Practice Address - Fax:410-544-4765
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTAO800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDX578OtherBLUE CROSS/ BLUE SHIELD
MDX578OtherBLUE CROSS/ BLUE SHIELD