Provider Demographics
NPI:1902821382
Name:GORDEUK, BARBARA ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANN
Last Name:GORDEUK
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 1:4899 DURHAM RD
Mailing Address - Street 2:
Mailing Address - City:PIPERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18947
Mailing Address - Country:US
Mailing Address - Phone:267-229-4242
Mailing Address - Fax:215-504-1344
Practice Address - Street 1:38 WEST RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4301
Practice Address - Country:US
Practice Address - Phone:215-968-0203
Practice Address - Fax:215-504-1344
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0E006881T152W00000X
NJ04955152W00000X
NJT0325152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0192730000OtherINDEPENDENCE BLUE CROSS
PA6881OtherEYMED
PA01851714Medicaid
57599OtherAETNA
53028OtherDAVIS
PA6881OtherEYMED
NJU609090Medicare UPIN