Healthcare Provider Details

I. General information

NPI: 1437260593
Provider Name (Legal Business Name): FERTILITY INSTITUTE OF NJ & NY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 KINDERKAMACK RD SUITE 200
ORADELL NJ
07649
US

IV. Provider business mailing address

680 KINDER KANAEK RD SUITE 200
ORADELL NJ
07649
US

V. Phone/Fax

Practice location:
  • Phone: 201-666-4200
  • Fax: 201-666-2262
Mailing address:
  • Phone: 201-666-4200
  • Fax: 201-666-2262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0006X
TaxonomyAmbulatory Fertility Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. SARAH M MARODA
Title or Position: PRACTICE MAN
Credential:
Phone: 201-666-4200