Provider Demographics
NPI:1659440485
Name:CENTER FOR ADVANCED REPRODUCTIVE SERVICES, PC
Entity type:Organization
Organization Name:CENTER FOR ADVANCED REPRODUCTIVE SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-678-5585
Mailing Address - Street 1:2 BATTERSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2568
Mailing Address - Country:US
Mailing Address - Phone:860-679-4580
Mailing Address - Fax:860-678-3435
Practice Address - Street 1:2 BATTERSON PARK RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2568
Practice Address - Country:US
Practice Address - Phone:860-679-4580
Practice Address - Fax:860-678-3435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT=========OtherTAX IDENTIFICATION NUMBER