Provider Demographics
NPI:1013372366
Name:WOODBRIDGE INFERTILITY INSTITUTE
Entity Type:Organization
Organization Name:WOODBRIDGE INFERTILITY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRSIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLEY
Authorized Official - Middle Name:K
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-494-0064
Mailing Address - Street 1:14904 JEFFERSON
Mailing Address - Street 2:DAVIS HIGHWAY
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191
Mailing Address - Country:US
Mailing Address - Phone:703-494-0064
Mailing Address - Fax:703-494-0384
Practice Address - Street 1:14904 JEFFERSON DAVIS HWY
Practice Address - Street 2:DAVIS HIGHWAY
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3908
Practice Address - Country:US
Practice Address - Phone:703-494-0064
Practice Address - Fax:703-494-0384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA27410261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center