NPI | 1023675220 |
---|---|
Former Legal Business Name | SHADY GROVE FERTILITY NEW YORK MEDICAL PROFESSIONALS, PLLC |
Entity Type | Organization |
Authorized Contact | SHELLY SHAPIRO Chief Financial Officer 301-545-1407 |
Organization Subpart ? | No |
Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology |
Enumeration Date | 2019-05-22 |
Last Update Date | 2019-08-13 |