Healthcare Provider Details
I. General information
NPI: 1497117113
Provider Name (Legal Business Name): FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2016
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
735 CHESTERBROOK BLVD SUITE 110
CHESTERBROOK PA
19087-5638
US
IV. Provider business mailing address
9600 BLACKWELL ROAD SUITE 500
ROCKVILLE MD
20850-3783
US
V. Phone/Fax
- Phone: 610-981-6000
- Fax: 855-437-5785
- Phone: 301-340-1188
- Fax: 855-716-1603
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VICKI
GERBER
Title or Position: EXECUTIVE MANAGING DIRECTOR
Credential:
Phone: 301-545-1248