Provider Demographics
NPI:1881874774
Name:NY AND NJ REPRODUCTIVE SERVICES PC
Entity type:Organization
Organization Name:NY AND NJ REPRODUCTIVE SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDEIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-963-6767
Mailing Address - Street 1:PO BOX 204
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-0204
Mailing Address - Country:US
Mailing Address - Phone:718-963-6767
Mailing Address - Fax:718-963-6363
Practice Address - Street 1:11015 71ST RD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4951
Practice Address - Country:US
Practice Address - Phone:718-963-6767
Practice Address - Fax:718-963-6363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162235174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty