Provider Demographics
NPI:1669478046
Name:INFERTILITY & INVITRO FERTILIZATION MEDICAL ASSOCIATES OF WNY PLLC
Entity Type:Organization
Organization Name:INFERTILITY & INVITRO FERTILIZATION MEDICAL ASSOCIATES OF WNY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:SPERRAZZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-839-1477
Mailing Address - Street 1:4510 MAIN STREET
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:SNYDER
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-839-3057
Mailing Address - Fax:716-839-1477
Practice Address - Street 1:4510 MAIN STREET
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SNYDER
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-839-3057
Practice Address - Fax:716-839-1477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119764207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB71573Medicare UPIN
NYBB5316Medicare ID - Type Unspecified