Provider Demographics
NPI:1346855483
Name:ROCKEFELLER FERTILITY LABORATORY INC.
Entity Type:Organization
Organization Name:ROCKEFELLER FERTILITY LABORATORY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLO
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:BSMT
Authorized Official - Phone:917-545-2065
Mailing Address - Street 1:7 W 51ST ST FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6905
Mailing Address - Country:US
Mailing Address - Phone:212-651-7515
Mailing Address - Fax:
Practice Address - Street 1:7 W 51ST ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6905
Practice Address - Country:US
Practice Address - Phone:212-651-7515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory