Provider Demographics
NPI:1558131656
Name:SUBURBAN RETINA SURGERY CENTER
Entity Type:Organization
Organization Name:SUBURBAN RETINA SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RISHI
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-240-1335
Mailing Address - Street 1:4989 PEACHTREE PKWY STE 211
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2589
Mailing Address - Country:US
Mailing Address - Phone:770-246-1335
Mailing Address - Fax:
Practice Address - Street 1:4989 PEACHTREE PKWY STE 211
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-2589
Practice Address - Country:US
Practice Address - Phone:770-246-1335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty