THE RETINA GROUP OF WASHINGTON, PLLC
Complete NPI Record 1568201416
Optometrist in Havre De Grace, MD
NPI Status: Active since May 21, 2024
- NPI
- Entity Type Code
- Employer Identification Number EIN
- Provider Organization Name Legal Business Name
- Provider First Line Business Mailing Address
- Provider Business Mailing Address City Name
- Provider Business Mailing Address State Name
- Provider Business Mailing Address Postal Code
- Provider Business Mailing Address Country Code If outside U S
- Provider First Line Business Practice Location Address
- Provider Business Practice Location Address City Name
- Provider Business Practice Location Address State Name
- Provider Business Practice Location Address Postal Code
- Provider Business Practice Location Address Country Code If outside U S
- Provider Business Practice Location Address Telephone Number
- Provider Enumeration Date
- Last Update Date
- Authorized Official Last Name
- Authorized Official First Name
- Authorized Official Middle Name
- Authorized Official Title or Position
- Authorized Official Telephone Number
- Healthcare Provider Taxonomy Code 1
- Healthcare Provider Primary Taxonomy Switch 1
- Healthcare Provider Taxonomy Code 2
- Healthcare Provider Primary Taxonomy Switch 2
- Is Organization Subpart
- Parent Organization LBN
- Parent Organization TIN
- Authorized Official Credential Text
- Healthcare Provider Taxonomy Group 1
- Healthcare Provider Taxonomy Group 2
- NPI Certification Date
Complete NPI Dataset
This page represents the complete record for NPI 1568201416. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.
- NPI: 1568201416
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Entity Type Code: 2
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: UNAVAIL
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: THE RETINA GROUP OF WASHINGTON, PLLC
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Provider First Line Business Mailing Address: 420 MOUNTAIN AVE FL 4
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Business Mailing Address City Name: NEW PROVIDENCE
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Business Mailing Address State Name: NJ
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Business Mailing Address Postal Code: 079742736
- The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
- Provider Business Mailing Address Country Code If outside U S : US
- The city name in the mailing address of the provider being identified.
- Provider First Line Business Practice Location Address: 2023 PULASKI HWY
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
- Provider Business Practice Location Address City Name: HAVRE DE GRACE
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
- Provider Business Practice Location Address State Name: MD
- The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
- Provider Business Practice Location Address Postal Code: 210782137
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
- Provider Business Practice Location Address Country Code If outside U S : US
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
- Provider Business Practice Location Address Telephone Number: 4109396477
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Enumeration Date: 5/21/2024
- The country code in the location address of the provider being identified.
- Last Update Date: 5/21/2024
- The telephone number associated with the location address of the provider being identified.
- The date the provider was assigned a unique identifier (assigned an NPI).
- The date that a record was last updated or changed.
- The code designating the provider’s gender if the provider is a person.
- Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
- Healthcare Provider Taxonomy Code 1: 152W00000X
- The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
- Healthcare Provider Primary Taxonomy Switch 1: Y
- Healthcare Provider Taxonomy Code 2: 207W00000X
- Healthcare Provider Primary Taxonomy Switch 2: N
- Is Organization Subpart: Y
- Parent Organization LBN: THE RETINA GROUP OF WASHINGTON, PLLC
- Parent Organization TIN: UNAVAIL
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
- Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP
- NPI Certification Date: 5/21/2024