Healthcare Provider Details

I. General information

NPI: 1841869559
Provider Name (Legal Business Name): ASSOCIATED RETINAL CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 S LINCOLN AVE
VINELAND NJ
08361-7802
US

IV. Provider business mailing address

420 MOUNTAIN AVE FL 4
NEW PROVIDENCE NJ
07974-2736
US

V. Phone/Fax

Practice location:
  • Phone: 856-691-8188
  • Fax: 856-691-0421
Mailing address:
  • Phone: 908-458-8313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: STEVEN MADREPERLA
Title or Position: PRESIDENT/CEO
Credential: MD, PHD
Phone: 908-458-8321