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General NPI Number Information
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NPI Number | 1891978219
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR ADVANCED REPRODUCTIVE SERVICES, PC
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 01/01/2015
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Provider Practice Location Address
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Address Line | 2 BATTERSON PARK RD
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City | FARMINGTON
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State | CT
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Zip | 06032-2568
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Country | US
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Telephone | 860-679-4580
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Fax | 860-679-3639
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Provider Business Mailing Address
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Address Line | 2 BATTERSON PARK RD
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City | FARMINGTON
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State | CT
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Zip | 06032-2568
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Country | US
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Telephone | 860-679-4580
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Fax | 860-679-3639
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Authorized Official
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Title or Position | VP, MANAGED CARE CONTRACTING, IVS
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Name | MS. DIANE RAVECH
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Credential |
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Telephone | 860-678-3428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 07D0709026
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License Number State | CT
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