Provider Demographics
NPI:1366796252
Name:BOSTON IVF FERTILITY SERVICES AT THE WOMEN'S HOSPITAL LLC
Entity type:Organization
Organization Name:BOSTON IVF FERTILITY SERVICES AT THE WOMEN'S HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-842-4222
Mailing Address - Street 1:4199 GATEWAY BLVD
Mailing Address - Street 2:SUITE 2600
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8940
Mailing Address - Country:US
Mailing Address - Phone:812-842-4530
Mailing Address - Fax:812-842-4535
Practice Address - Street 1:4199 GATEWAY BLVD
Practice Address - Street 2:SUITE 2600
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8940
Practice Address - Country:US
Practice Address - Phone:812-842-4530
Practice Address - Fax:812-842-4535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty