Provider Demographics
NPI:1457091159
Name:IVF LABORATORIES OF VERMONT, LLC
Entity Type:Organization
Organization Name:IVF LABORATORIES OF VERMONT, LLC
Other - Org Name:OVATION FERTILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPPELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-858-1080
Mailing Address - Street 1:15821 VENTURA BLVD STE 625
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4780
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 WESTVIEW RD STE 302
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-8025
Practice Address - Country:US
Practice Address - Phone:818-858-1080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-30
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory