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NPI Code Detail

MEDICARE: RETINA ASSOCIATES OF GREATER PHILA., LTD

MEDICARE: RETINA ASSOCIATES OF GREATER PHILA., LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician

General Provider Information

NPI Number : 1336181601
Entity Type Code : Organization
Provider Name (Legal Business Name) : RETINA ASSOCIATES OF GREATER PHILA., LTD
Provider Business Mailing Address
First Line : 124 DEKALB PIKE
Second Line :
City : NORTH WALES
State : PA
Zip : 19454-1853
Country : US
Telephone Number : 215-699-7600
Fax Number : 215-699-8867
Provider Business Practice Location Address
First Line : 124 DEKALB PIKE
Second Line :
City : NORTH WALES
State : PA
Zip : 19454-1853
Country : US
Telephone Number : 215-699-7600
Fax Number : 215-699-8867
Authorized Official
Title or Position : BILLING MANAGER
Name : MRS. EILEEN SUSAN RYMDEIKA
Credential :
Telephone Number : 215-699-7600
Provider Enumeration Date : 06/12/2006
Last Update Date : 11/02/2007

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