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NPI Code Detail

MEDICARE: RIVER VIEW FERTILITY MEDICINE, PC

MEDICARE: RIVER VIEW FERTILITY MEDICINE, PC
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
1261QA0006XAmbulatory Fertility Facility201579NY

General Provider Information

NPI Number : 1528328382
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVER VIEW FERTILITY MEDICINE, PC
Provider Business Mailing Address
First Line : 51 E 67TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10065-5949
Country : US
Telephone Number : 212-430-6009
Fax Number :
Provider Business Practice Location Address
First Line : 51 E 67TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10065-5949
Country : US
Telephone Number : 212-430-6009
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JESSE HADE
Credential : MD
Telephone Number : 212-430-6009
Provider Enumeration Date : 05/25/2012
Last Update Date : 05/25/2012

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