Healthcare Provider Details
I. General information
NPI: 1952264194
Provider Name (Legal Business Name): ESSE INTEGRATED REPRODUCTIVE WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
204 CORLIES AVE
PELHAM NY
10803-1904
US
IV. Provider business mailing address
204 CORLIES AVE
PELHAM NY
10803-1904
US
V. Phone/Fax
- Phone: 646-844-9602
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KARLI
PROVOST
GOLDSTEIN
Title or Position: CEO
Credential:
Phone: 646-844-9602