Provider Demographics
NPI:1669434700
Name:MAIN LINE FERTILITY & REPRODUCTIVE MED LTD
Entity type:Organization
Organization Name:MAIN LINE FERTILITY & REPRODUCTIVE MED LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:PFEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-527-0800
Mailing Address - Street 1:130 S BRYN MAWR AVE
Mailing Address - Street 2:SUITE 1000 D WING
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3121
Mailing Address - Country:US
Mailing Address - Phone:610-527-0800
Mailing Address - Fax:610-527-9868
Practice Address - Street 1:130 S BRYN MAWR AVE
Practice Address - Street 2:SUITE 1000 D WING
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3121
Practice Address - Country:US
Practice Address - Phone:610-527-0800
Practice Address - Fax:610-527-9868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA035210Medicare ID - Type Unspecified