MEDICARE: RETINA FIRST LLC

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
1	207WX0107X	Retina Specialist (Ophthalmology) Physician

General Provider Information

NPI Number	:	1588296610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RETINA FIRST LLC

Provider Business Mailing Address
First Line	:	1502 S MAIN ST STE 305
Second Line	:
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-5374
Country	:	US
Telephone Number	:	301-703-8856
Fax Number	:	301-703-8857

Provider Business Practice Location Address
First Line	:	1502 S MAIN ST STE 305
Second Line	:
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-5374
Country	:	US
Telephone Number	:	516-922-9571
Fax Number	:	516-922-2288

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	INGRID ZIMMER-GALLER
Credential	:	MD
Telephone Number	:	301-703-8856

Provider Enumeration Date	:	02/06/2020
Last Update Date	:	04/06/2026

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Directions to “RETINA FIRST LLC ” Practice Location

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