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Contact Information

NORTHEAST RETINA ASSOCIATES, PA
272 COTTAGE ST
SANFORD, ME04073-1815
 Phone: 207-324-3380
 Fax: 207-636-5023
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for NORTHEAST RETINA ASSOCIATES, PA

NPI # 1124005590
LBN Legal business name NORTHEAST RETINA ASSOCIATES, PA
Authorized official JENNIFER BREAREY - (OPHTHALMIC MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/28/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
ME License # 013866
NH License # 9375
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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