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General NPI Number Information
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NPI Number | 1508641408
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Entity Type | Organization
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Legal Business Name | CONCIERGE FERTILITY & WOMEN'S HEALTH
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 1540 ROUTE 202 STE 1B
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City | POMONA
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State | NY
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Zip | 10970-2923
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Country | US
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Telephone | 914-589-0908
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Fax |
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Provider Business Mailing Address
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Address Line | 19 N 3RD ST
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-5258
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Country | US
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Telephone | 914-589-0908
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | GLORIA MOONEY
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Credential |
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Telephone | 914-589-0908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175M00000X
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Taxonomy Name | Lay Midwife
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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