# RETINA ASSOCIATES OF CLEVELAND, INC.

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

## Provider details

- **NPI number:** 1912991225
- **Authorized official:** NICOLE LAUGHLIN (DIRECTOR OF REVENUE)
- **Authorized official phone:** (216) 831-5704

## Contact information

- **Practice address:** 24075 COMMERCE PARK, BEACHWOOD, OH 44122-5846
- **Practice address phone:** (216) 831-5700
- **Practice address fax:** (216) 831-1959
- **Mailing address:** 24075 COMMERCE PARK, BEACHWOOD, OH 44122-5846
- **Mailing address phone:** (216) 831-5700
- **Mailing address fax:** (216) 831-1959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/01/2005
- **Last updated:** 03/24/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0491310 | — | OH |