Healthcare Provider Details
I. General information
NPI: 1609479054
Provider Name (Legal Business Name): REPRODUCTIVE CENTERS OF AMERICA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2020
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12 DAYBREAK LN
WESTPORT CT
06880-2157
US
IV. Provider business mailing address
12 DAYBREAK LN
WESTPORT CT
06880-2157
US
V. Phone/Fax
- Phone: 475-377-0737
- Fax: 475-377-0737
- Phone: 917-837-5802
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOAO
FELDMAN CORREIA
DE PINHO
Title or Position: MANAGER, MEDICAL DIRECTOR
Credential: MD, FACOG
Phone: 917-837-5802