MEDICARE: NEW ENGLAND FERTILITY INSTITUTE LLC

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	291U00000X	Clinical Medical Laboratory	07D0865635	CT

General Provider Information

NPI Number	:	1942211974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW ENGLAND FERTILITY INSTITUTE LLC

Provider Business Mailing Address
First Line	:	1275 SUMMER STREET
Second Line	:	SUITE 201
City	:	STAMFORD
State	:	CT
Zip	:	06905
Country	:	US
Telephone Number	:	203-325-3200
Fax Number	:	203-323-3130

Provider Business Practice Location Address
First Line	:	1275 SUMMER ST
Second Line	:	SUITE 201
City	:	STAMFORD
State	:	CT
Zip	:	06905-5359
Country	:	US
Telephone Number	:	203-325-3200
Fax Number	:	203-323-3130

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JOHN EDWARD BARNEY
Credential	:
Telephone Number	:	203-325-3200

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	07/31/2008

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