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DELAWARE VALLEY RETINA ASSOCIATES PC NPI 1336193994


NPI Information

NPI: 1336193994
Provider Name: DELAWARE VALLEY RETINA ASSOCIATES PC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 31D1069721

Address:
4 PRINCESS RD
BUILDING 100, SUITE 101
LAWRENCEVILLE, NJ
ZIP 08648
Phone: (609) 896-1414
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DELAWARE VALLEY RETINA ASSOCIATES PC is an ophthalmology in Lawrenceville, NJ. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. DELAWARE VALLEY RETINA ASSOCIATES PC NPI is 1336193994. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4 PRINCESS RD
BUILDING 100, SUITE 101
LAWRENCEVILLE, NJ
ZIP 08648-322
Phone: (609) 896-1414
Fax: (609) 896-2982

The provider's authorized official is Darmakusuma Ie .
The authorized official title is Vice President and has the following contact phone number (609) 896-1414.

The CLIA number assigned to this NPI record is 31D1069721 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 4/23/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11336193994OTHERNEW JERSEYCHAMPUS/TRICARE PGBA
2CI9130OTHERNEW JERSEYRAILROAD MEDICARE
3195761MEDICARE PINNEW JERSEY
4195748MEDICARE PINPENNSYLVANIA
5CC5703OTHERNEW JERSEYRAILROAD MEDICARE
6CI9131OTHERPENNSYLVANIARAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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