Provider Demographics
NPI:1629145370
Name:RETINA ASSOCIATES OF NEW YORK,P.C.
Entity Type:Organization
Organization Name:RETINA ASSOCIATES OF NEW YORK,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:ZANE
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-772-0600
Mailing Address - Street 1:140 E 80TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0306
Mailing Address - Country:US
Mailing Address - Phone:212-772-0600
Mailing Address - Fax:212-517-8028
Practice Address - Street 1:140 E 80TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0306
Practice Address - Country:US
Practice Address - Phone:212-772-0600
Practice Address - Fax:212-517-8028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW35201Medicare ID - Type Unspecified