Healthcare Provider Details

I. General information

NPI: 1346855483
Provider Name (Legal Business Name): ROCKEFELLER FERTILITY LABORATORY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 W 51ST ST FL 5
NEW YORK NY
10019-6905
US

IV. Provider business mailing address

7 W 51ST ST FL 5
NEW YORK NY
10019-6905
US

V. Phone/Fax

Practice location:
  • Phone: 212-651-7515
  • Fax:
Mailing address:
  • Phone: 212-651-7515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: CARLO ACOSTA
Title or Position: OWNER
Credential: BSMT
Phone: 917-545-2065