Organization
ILLUME FERTILITY, PLLC
Active
Other names
Ambulatory Surgical Center at Reproductive Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN MANGIERI (CEO)
(203) 750-7400
Entity
Organization
Contact information
Practice address
761 MAIN AVE, SUITE 200, NORWALK, CT 06851-1080
(203) 750-7400
Mailing address
761 MAIN AVE, SUITE 200, NORWALK, CT 06851-1080
(203) 750-7400
Taxonomy
Speciality
Code
Description
License number
State
261QA0006X
Ambulatory Fertility Facility
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
0320
CT
Other
Enumeration date
07/01/2008
Last updated
04/04/2022
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