Healthcare Provider Details

I. General information

NPI: 1114538394
Provider Name (Legal Business Name): REJUVENATING FERTILITY CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 MAIN ST
WESTPORT CT
06880-3216
US

IV. Provider business mailing address

225 MAIN ST STE 101
WESTPORT CT
06880-3216
US

V. Phone/Fax

Practice location:
  • Phone: 718-801-9153
  • Fax:
Mailing address:
  • Phone: 203-557-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0006X
TaxonomyAmbulatory Fertility Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. ZAHER MERHI
Title or Position: DIRECTOR
Credential: MD
Phone: 203-557-9696