MEDICARE: INSTITUTE FOR REPRODUCTIVE MEDICINE AND SCIENCE AT SAINT BARNABAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VE0102X	Reproductive Endocrinology Physician

General Provider Information

NPI Number	:	1003053729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSTITUTE FOR REPRODUCTIVE MEDICINE AND SCIENCE AT SAINT BARNABAS

Provider Business Mailing Address
First Line	:	94 OLD SHORT HILLS RD
Second Line	:	EAST WING, SUITE 403
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-5672
Country	:	US
Telephone Number	:	973-322-8286
Fax Number	:	973-322-8890

Provider Business Practice Location Address
First Line	:	609 WASHINGTON ST
Second Line	:	2ND FLOOR
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4907
Country	:	US
Telephone Number	:	201-963-7640
Fax Number	:	201-204-9319

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARGARET GRAF GARRISI
Credential	:	M.D.
Telephone Number	:	973-322-8286

Provider Enumeration Date	:	01/16/2009
Last Update Date	:	01/16/2009

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