Healthcare Provider Details

I. General information

NPI: 1467117820
Provider Name (Legal Business Name): SPRING FERTILITY NEW JERSEY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 11/15/2021
Certification Date: 11/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 JOURNAL SQ STE 528
JERSEY CITY NJ
07306-4029
US

IV. Provider business mailing address

1 DANIEL BURNHAM CT STE 110C
SAN FRANCISCO CA
94109-0456
US

V. Phone/Fax

Practice location:
  • Phone: 415-964-5618
  • Fax:
Mailing address:
  • Phone: 415-964-5618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER KLATSKY
Title or Position: MEMBER
Credential: MD
Phone: 415-964-5618