Basic Information
| Provider Information | |||||||||
| NPI: | 1073155974 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSOCIATED RETINAL CONSULTANTS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 GALLOPING HILL RD STE 304 | ||||||||
| Address2: | |||||||||
| City: | UNION | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070837991 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9084588333 | ||||||||
| FaxNumber: | 9088454010 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 PAVONIA AVE STE 6 | ||||||||
| Address2: | |||||||||
| City: | JERSEY CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 073062932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019633937 | ||||||||
| FaxNumber: | 2019638823 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2019 | ||||||||
| LastUpdateDate: | 10/11/2019 | ||||||||
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| AuthorizedOfficialLastName: | MADREPERLA | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9084588333 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HUDSON EYE PHYSICIANS & SURGEONS- DME | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.