Healthcare Provider Details

I. General information

NPI: 1497914774
Provider Name (Legal Business Name): EAST COAST FERTILITY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1074 OLD COUNTRY RD
PLAINVIEW NY
11803-4918
US

IV. Provider business mailing address

1074 OLD COUNTRY RD
PLAINVIEW NY
11803-4918
US

V. Phone/Fax

Practice location:
  • Phone: 516-939-6695
  • Fax: 516-939-2392
Mailing address:
  • Phone: 516-939-6695
  • Fax: 516-939-2392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number151798-1
License Number StateNY

VIII. Authorized Official

Name: MARYANNE ABRAMOWITZ
Title or Position: BILLING ADMINISTRATOR
Credential:
Phone: 516-939-6695