Provider Demographics
NPI:1679603492
Name:RETINA ASSOCIATES OF NORTHWEST NEW JERSEY, P.A.
Entity Type:Organization
Organization Name:RETINA ASSOCIATES OF NORTHWEST NEW JERSEY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SACHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-539-3600
Mailing Address - Street 1:8 SADDLE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927-1902
Mailing Address - Country:US
Mailing Address - Phone:973-539-3600
Mailing Address - Fax:973-539-7576
Practice Address - Street 1:8 SADDLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-1902
Practice Address - Country:US
Practice Address - Phone:973-539-3600
Practice Address - Fax:973-539-7576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA58749207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5459001Medicaid
NJF22003Medicare UPIN
NJ5459001Medicaid