Healthcare Provider Details

I. General information

NPI: 1437179942
Provider Name (Legal Business Name): MONMOUTH RETINA CONSULTANTS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 SYCAMORE AVE.
LITTLE SILVER NJ
07739
US

IV. Provider business mailing address

39 SYCAMORE AVE.
LITTLE SILVER NJ
07739
US

V. Phone/Fax

Practice location:
  • Phone: 732-530-7730
  • Fax: 732-530-3837
Mailing address:
  • Phone: 732-530-7730
  • Fax: 732-530-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH GIRA
Title or Position: MANAGER
Credential: M.D.
Phone: 314-909-0633