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General NPI Number Information
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NPI Number | 1508660325
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Entity Type | Organization
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Legal Business Name | TERRA FERTILITY PLLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 45 STERGIS WAY
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City | DEDHAM
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State | MA
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Zip | 02026-2637
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Country | US
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Telephone | 305-495-7446
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Fax |
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Provider Business Mailing Address
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Address Line | 45 STERGIS WAY
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City | DEDHAM
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State | MA
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Zip | 02026-2637
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Country | US
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Telephone | 781-675-3192
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Fax | 781-747-6754
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | AMANDA LAYNE
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Credential |
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Telephone | 781-675-3192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number |
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License Number State |
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