Healthcare Provider Details
I. General information
NPI: 1164578894
Provider Name (Legal Business Name): ASSOCIATED RETINAL CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/26/2007
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 CENTURIAN DR STE 114
NEWARK DE
19713-2154
US
IV. Provider business mailing address
420 MOUNTAIN AVE FL 4
NEW PROVIDENCE NJ
07974-2736
US
V. Phone/Fax
- Phone: 908-458-8333
- Fax:
- Phone: 908-458-8333
- Fax: 908-967-5488
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207WX0107X |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
MADREPERLA
Title or Position: OWNER/CEO
Credential: MD, PHD
Phone: 908-458-8333