1730379074 NPI number — SHER INSTITUTE FOR REPRODUCTIVE MEDICINE

Table of content: (NPI 1730379074)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730379074 NPI number — SHER INSTITUTE FOR REPRODUCTIVE MEDICINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHER INSTITUTE FOR REPRODUCTIVE MEDICINE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1730379074
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5320 S RAINBOW BLVD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89118-1840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-974-0073
Provider Business Mailing Address Fax Number:
702-696-0554

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1131 BROAD ST
Provider Second Line Business Practice Location Address:
#104
Provider Business Practice Location Address City Name:
SHREWSBURY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07702-4329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-798-2229
Provider Business Practice Location Address Fax Number:
908-781-6377
Provider Enumeration Date:
08/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DLUGHI
Authorized Official First Name:
ALEXANDER
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
908-781-0666

Provider Taxonomy Codes

  • Taxonomy code: 207VX0201X , with the licence number:  25MA06916000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VE0102X , with the licence number: 25MA06916000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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