Provider Demographics
NPI:1023675220
Name:NEW YORK FERTILITY MEDICAL PRACTICE, PLLC
Entity type:Organization
Organization Name:NEW YORK FERTILITY MEDICAL PRACTICE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-545-1407
Mailing Address - Street 1:9600 BLACKWELL ROAD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3783
Mailing Address - Country:US
Mailing Address - Phone:301-340-1188
Mailing Address - Fax:
Practice Address - Street 1:110 EAST 60TH STREET
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1688
Practice Address - Country:US
Practice Address - Phone:888-761-1967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty