Retina Diagnostic & Treatment Associates, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

RETINA DIAGNOSTIC & TREATMENT ASSOCIATES, LLC

Practice address

840 Walnut St
Suite 1020
Philadelphia, PA 19107-5109

Phone

(215) 928-3300

Fax

(215) 825-4723

NPI assigned

Jun 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary C Brown, MD

Title

MD

Phone

(215) 928-3300

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1093752495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST",
            "address_2": "SUITE 1020",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-928-3300",
            "fax_number": "215-825-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST",
            "address_2": "SUITE 1020",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-928-3300",
            "fax_number": "215-825-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA DIAGNOSTIC & TREATMENT ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "215-928-3300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101472321-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hanna Retallack
• Carolina I Retamero, M.D.
• Retap Life PLLC
• Leah B Rethy, MD
• Jennifer Retig, PA
• Michele Retrouvey, MD
• Mia Kathryn Retter, CCC-SLP
• Jordan Rettig, M.D.
• Patricia Ann Rettig, RN CRNP
• Richard Rettig, D.P.M.

• Ophthalmology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.