Healthcare Provider Details

I. General information

NPI: 1821489832
Provider Name (Legal Business Name): NEW YORK FERTILITY INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2015
Last Update Date: 02/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 5TH AVE
NEW YORK NY
10028-0132
US

IV. Provider business mailing address

1016 5TH AVE
NEW YORK NY
10028-0132
US

V. Phone/Fax

Practice location:
  • Phone: 212-734-5555
  • Fax: 212-734-6059
Mailing address:
  • Phone: 212-734-5555
  • Fax: 212-734-6059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number155102
License Number StateNY

VIII. Authorized Official

Name: DR. MAJID FATEH
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 212-734-5555