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General NPI Number Information
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NPI Number | 1225744782
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Entity Type | Organization
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Legal Business Name | RETINA ASSOCIATES OF LANCASTER, LLC
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Dates
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Enumeration Date | 01/27/2023
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 2148 EMBASSY DR STE 100
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City | LANCASTER
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State | PA
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Zip | 17603-2385
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Country | US
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Telephone | 717-925-0917
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Fax |
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Provider Business Mailing Address
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Address Line | 2148 EMBASSY DR STE 100
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City | LANCASTER
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State | PA
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Zip | 17603-2385
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CONTRACTING
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Name | ROSE FLOSSER
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Credential |
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Telephone | 717-371-1168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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