Provider Demographics
NPI:1184737652
Name:ASSOCIATED RETINAL SURGEONS
Entity type:Organization
Organization Name:ASSOCIATED RETINAL SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:DANA
Authorized Official - Last Name:REGILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-667-2246
Mailing Address - Street 1:501 COOPER LANDING RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002
Mailing Address - Country:US
Mailing Address - Phone:856-667-2246
Mailing Address - Fax:856-667-2238
Practice Address - Street 1:501 COOPER LANDING RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002
Practice Address - Country:US
Practice Address - Phone:856-667-2246
Practice Address - Fax:856-667-2238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3902005OtherMEDICAL ASSISTANCE
NJ3902005OtherMEDICAL ASSISTANCE