Provider Demographics
NPI:1447283510
Name:EDISON, BARRY J (DO)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:J
Last Name:EDISON
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Gender:M
Credentials:DO
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Mailing Address - Street 1:10 INDUSTRIAL WAY E
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3332
Mailing Address - Country:US
Mailing Address - Phone:732-542-0300
Mailing Address - Fax:732-935-0533
Practice Address - Street 1:10 INDUSTRIAL WAY E
Practice Address - Street 2:SUITE 102
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3332
Practice Address - Country:US
Practice Address - Phone:732-542-0300
Practice Address - Fax:732-935-0533
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2015-05-28
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Provider Licenses
StateLicense IDTaxonomies
NJMB72146207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ180046261OtherRAILROAD MEDICARE
NJH19649Medicare UPIN
NJ087069Medicare PIN