=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679641443
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REPRODUCTIVE GYNECOLOGY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 95 ARCH ST STE 250
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-375-7722
-----------------------------------------------------
Fax | 330-253-6708
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 95 ARCH ST STE 250
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-375-7722
-----------------------------------------------------
Fax | 330-253-6708
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE OWNER
-----------------------------------------------------
Name | DR. RICHARD W MORETUZZO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 330-375-7722
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VE0102X
-----------------------------------------------------
Taxonomy Name | Reproductive Endocrinology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------