# THE RETINA GROUP OF WASHINGTON, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE RETINA GROUP OF WASHINGTON, PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1578303632
- **Legal business name:** THE RETINA GROUP OF WASHINGTON, PLLC
- **Authorized official:** STEVEN MADREPERLA MD, PHD (PRESIDENT AND CEO)
- **Authorized official phone:** (908) 458-8333

## Contact information

- **Practice address:** 2023 PULASKI HWY, HAVRE DE GRACE, MD 21078-2137
- **Practice address phone:** (410) 939-6477
- **Mailing address:** 420 MOUNTAIN AVE FL 4, NEW PROVIDENCE, NJ 07974-2736
- **Mailing address phone:** (908) 458-8333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/28/2024
- **Last updated:** 05/28/2024