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Organization

INTEGRATED REPRODUCTIVE SURGERY LLC

Active
Other names
Esse Care and Wellness LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRANDON PROVOST (COO)
(832) 515-6129
Entity
Organization

Contact information

Practice address
779 NORTH ST, GREENWICH, CT 06831-3105
(646) 844-9602
Mailing address
204 CORLIES AVE, PELHAM, NY 10803-1904
(646) 844-9602

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1235574559
NPI
NY
01
1538393194
NPI
NY
Enumeration date
05/24/2023
Last updated
05/28/2025
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