Healthcare Provider Details

I. General information

NPI: 1508291220
Provider Name (Legal Business Name): BOSTON IVF THE ARIZONA CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2013
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 E MOUNTAIN VIEW RD STE 201
SCOTTSDALE AZ
85258-4424
US

IV. Provider business mailing address

8901 E MOUNTAIN VIEW RD STE 201
SCOTTSDALE AZ
85258-4424
US

V. Phone/Fax

Practice location:
  • Phone: 480-559-0252
  • Fax: 480-661-4141
Mailing address:
  • Phone: 480-559-0252
  • Fax: 480-661-4141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number1083644
License Number StateAZ

VIII. Authorized Official

Name: DR. RITA M SNEERINGER
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 480-559-0252