NPI 1124005590 · live from the CMS NPI Registry
Northeast Retina Associates, PA
Ophthalmology in Sanford, ME. National Provider Identifier 1124005590, active.
NPI record
| NPI | 1124005590 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 272 Cottage St, Sanford, ME 04073 |
| Practice phone | 207-324-3380 |
| Enumerated | December 28, 2005 |
| Last updated | August 22, 2020 |
| Authorized official | Jennifer Brearey, Ophthalmic Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology | 207W00000X | 9375 (NH) |
| Ophthalmology primary | 207W00000X | 013866 (ME) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.