Healthcare Provider Details

I. General information

NPI: 1154389831
Provider Name (Legal Business Name): DELAWARE VALLEY INSTITUTE OF FERTILITY & GENETICS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 SAGEMORE DR SUITE 6102
MARLTON NJ
08053-3900
US

IV. Provider business mailing address

6000 SAGEMORE DR SUITE 6102
MARLTON NJ
08053-3900
US

V. Phone/Fax

Practice location:
  • Phone: 856-988-0072
  • Fax: 856-988-7308
Mailing address:
  • Phone: 856-988-0072
  • Fax: 856-988-7308

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: DR. GEORGE S TALIADOUROS
Title or Position: PRESIDENT
Credential: MD
Phone: 856-988-0072