Provider Demographics
NPI:1427078930
Name:RETINA CONSULTANTS SURGERY CENTER
Entity type:Organization
Organization Name:RETINA CONSULTANTS SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:URAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-530-7730
Mailing Address - Street 1:39 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1208
Mailing Address - Country:US
Mailing Address - Phone:732-530-7730
Mailing Address - Fax:732-530-3837
Practice Address - Street 1:39 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1208
Practice Address - Country:US
Practice Address - Phone:732-530-7730
Practice Address - Fax:732-530-3837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical