Provider Demographics
NPI:1205081841
Name:CARNEY RETINA AND MACULA CENTER PC
Entity type:Organization
Organization Name:CARNEY RETINA AND MACULA CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-227-6340
Mailing Address - Street 1:PO BOX 61785
Mailing Address - Street 2:CARNEY RETINA MACULA CENTER PC
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23466-1785
Mailing Address - Country:US
Mailing Address - Phone:757-227-6340
Mailing Address - Fax:804-754-1428
Practice Address - Street 1:4433 CORPORATION LN
Practice Address - Street 2:CORPORATION IV SUITE 195
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3351
Practice Address - Country:US
Practice Address - Phone:757-227-6340
Practice Address - Fax:804-754-1428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101033260207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty