Healthcare Provider Details

I. General information

NPI: 1417450644
Provider Name (Legal Business Name): AMERICAN FERTILITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PUTNAM GRN
GREENWICH CT
06830-6877
US

IV. Provider business mailing address

100 PUTNAM GRN
GREENWICH CT
06830-6877
US

V. Phone/Fax

Practice location:
  • Phone: 203-774-9900
  • Fax:
Mailing address:
  • Phone: 203-774-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number54756
License Number StateCT

VIII. Authorized Official

Name: JOAO C DE PINHO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 203-774-9900