# SOUTHERN NEW ENGLAND RETINA ASSOCIATES, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548228794
- **Authorized official:** DR. MAGDALENA G KRZYSTOLIK M.D. (PRESIDENT)
- **Authorized official phone:** (401) 453-4600

## Contact information

- **Practice address:** 1 RANDALL SQ, SUITE 203, PROVIDENCE, RI 02904-2709
- **Practice address phone:** (401) 453-4600
- **Practice address fax:** (401) 453-0077
- **Mailing address:** 1 RANDALL SQ, SUITE 203, PROVIDENCE, RI 02904-2709
- **Mailing address phone:** (401) 453-4600
- **Mailing address fax:** (401) 453-0077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2006
- **Last updated:** 07/20/2011