Healthcare Provider Details
I. General information
NPI: 1891619391
Provider Name (Legal Business Name): RETINA CARE MASSACHUSETTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26 SURVEYORS LN
VINEYARD HAVEN MA
02568-6369
US
IV. Provider business mailing address
109 HARVEY ST
CAMBRIDGE MA
02140-1720
US
V. Phone/Fax
- Phone: 617-468-1741
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WARD
FICKWEILER
Title or Position: OWNER
Credential: MD, PHD
Phone: 857-285-1561