Provider Demographics
NPI:1558987701
Name:RETINA PHYSICIANS AND SURGEONS OF NEW ENGLAND, INC.
Entity Type:Organization
Organization Name:RETINA PHYSICIANS AND SURGEONS OF NEW ENGLAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARSAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-805-1013
Mailing Address - Street 1:54 HOPEDALE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HOPEDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01747-1732
Mailing Address - Country:US
Mailing Address - Phone:508-488-9770
Mailing Address - Fax:
Practice Address - Street 1:54 HOPEDALE ST STE 1
Practice Address - Street 2:
Practice Address - City:HOPEDALE
Practice Address - State:MA
Practice Address - Zip Code:01747-1732
Practice Address - Country:US
Practice Address - Phone:508-488-9770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic SurgeryGroup - Single Specialty