Provider Demographics
NPI:1063671014
Name:EAST COAST FERTILITY, P.C.
Entity Type:Organization
Organization Name:EAST COAST FERTILITY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GERACI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-605-1060
Mailing Address - Street 1:1074 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4918
Mailing Address - Country:US
Mailing Address - Phone:516-939-2229
Mailing Address - Fax:516-939-2252
Practice Address - Street 1:2233 NESCONSET HWY
Practice Address - Street 2:SUITE 107
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-1000
Practice Address - Country:US
Practice Address - Phone:516-939-2229
Practice Address - Fax:516-939-2252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty