Provider Demographics
NPI:1407133150
Name:EAST COAST FERTILITY, PC
Entity type:Organization
Organization Name:EAST COAST FERTILITY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:TODARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-939-6695
Mailing Address - Street 1:245 NEWTOWN RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4316
Mailing Address - Country:US
Mailing Address - Phone:516-939-6695
Mailing Address - Fax:516-501-6934
Practice Address - Street 1:2500 NESCONSET HIGHWAY
Practice Address - Street 2:BUILDING 19, SUITE 70
Practice Address - City:STONYBROOK
Practice Address - State:NY
Practice Address - Zip Code:11790
Practice Address - Country:US
Practice Address - Phone:516-939-6695
Practice Address - Fax:516-501-6934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty