Provider Demographics
NPI:1841788809
Name:MANHATTAN REPRODUCTIVE SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:MANHATTAN REPRODUCTIVE SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:DIMITRIOS
Authorized Official - Last Name:KOFINAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-819-2333
Mailing Address - Street 1:65 BROADWAY FL 21
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-2503
Mailing Address - Country:US
Mailing Address - Phone:212-807-7000
Mailing Address - Fax:212-433-2578
Practice Address - Street 1:65 BROADWAY FL 21
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-2503
Practice Address - Country:US
Practice Address - Phone:212-807-7000
Practice Address - Fax:212-433-2578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCORPORATION261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical