Provider Demographics
NPI:1295777605
Name:EAST COAST INFERTILITY AND IVF P C
Entity type:Organization
Organization Name:EAST COAST INFERTILITY AND IVF P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-758-6511
Mailing Address - Street 1:655 SHREWSBURY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4151
Mailing Address - Country:US
Mailing Address - Phone:732-758-6511
Mailing Address - Fax:732-758-1048
Practice Address - Street 1:655 SHREWSBURY AVE STE 300
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4151
Practice Address - Country:US
Practice Address - Phone:732-758-6511
Practice Address - Fax:732-758-6511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05329400174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty