Provider Demographics
NPI:1942211974
Name:NEW ENGLAND FERTILITY INSTITUTE LLC
Entity Type:Organization
Organization Name:NEW ENGLAND FERTILITY INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-325-3200
Mailing Address - Street 1:1275 SUMMER STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905
Mailing Address - Country:US
Mailing Address - Phone:203-325-3200
Mailing Address - Fax:203-323-3130
Practice Address - Street 1:1275 SUMMER ST
Practice Address - Street 2:SUITE 201
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5359
Practice Address - Country:US
Practice Address - Phone:203-325-3200
Practice Address - Fax:203-323-3130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT07D0865635291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTE82193Medicare UPIN