Provider Demographics
NPI:1639236714
Name:RETINA EYE CARE P.C.
Entity Type:Organization
Organization Name:RETINA EYE CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-903-0003
Mailing Address - Street 1:182 W CENTRAL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3756
Mailing Address - Country:US
Mailing Address - Phone:508-903-0003
Mailing Address - Fax:508-903-0005
Practice Address - Street 1:182 W CENTRAL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3756
Practice Address - Country:US
Practice Address - Phone:508-903-0003
Practice Address - Fax:508-903-0005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153637207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA152660OtherHARVARD PILGRIM NO
MAM17838OtherBCBS GROUP NUMBER
MA691958OtherTUFTS GROUP NUMBER
MACK8742OtherRAILROAD MEDICARE
MA9709436Medicaid
MA=========OtherUNITED HEALTHCARE
MACK8742OtherRAILROAD MEDICARE
MA9709436Medicaid
MAM17838OtherBCBS GROUP NUMBER
MA9709436Medicaid