Provider Demographics
NPI:1043498132
Name:RETINACARE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:RETINACARE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VITREO-RETINAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:570-972-1408
Mailing Address - Street 1:7400 ROUTE 611
Mailing Address - Street 2:SUITE 1
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-8384
Mailing Address - Country:US
Mailing Address - Phone:570-972-1408
Mailing Address - Fax:570-972-1407
Practice Address - Street 1:7400 ROUTE 611
Practice Address - Street 2:SUITE 1
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-8384
Practice Address - Country:US
Practice Address - Phone:570-972-1408
Practice Address - Fax:570-972-1407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty