The Retina Group Of Washington, PLLC
Ophthalmology in Bowie, MD. Organization (NPI-2).
NPI number1194585166
StatusActive
Last updated in NPPESMay 23, 2024
Details
- NPI
- 1194585166
- Entity type
- Organization (NPI-2)
- Legal business name
- The Retina Group Of Washington, PLLC
- Organization subpart
- No
- Enumeration date
- Mar 19, 2024
- Certification date
- May 23, 2024
- Last updated
- May 23, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | – | – | Yes |
Practice location
16901 Melford Blvd Ste 111Bowie, MD 20715-4449
Phone 301-805-5395 · Fax 301-805-5396
Mailing address
420 Mountain Ave Fl 4New Providence, NJ 07974-2736
Authorized official
Steven A Madreperla
Owner/Ceo
9084588321
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