# BRAVERMAN REPORDUCTIVE IMMUNOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649557695
- **Authorized official:** ANDREA VIDALI MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (516) 584-8710

## Contact information

- **Practice address:** 155 E 76TH ST STE 1H, NEW YORK, NY 10021-2810
- **Practice address phone:** (516) 584-8710
- **Practice address fax:** (516) 584-8711
- **Mailing address:** 135 PINELAWN RD STE 115, MELVILLE, NY 11747-3198
- **Mailing address phone:** (516) 584-8710
- **Mailing address fax:** (516) 584-8711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/04/2011
- **Last updated:** 05/31/2022