Organization
LONG ISLAND FERTILITY, PLLC
Active
Other names
Long Island IVF
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE RAVECH MPA (VICE PRESIDENT, MANAGED CARE)
(860) 678-3428
Entity
Organization
Contact information
Practice address
8 CORPORATE CENTER DR, SUITE 101, MELVILLE, NY 11747-3193
(631) 752-0606
(631) 331-1332
Mailing address
8 CORPORATE CENTER DR, SUITE 101, MELVILLE, NY 11747-3193
(631) 752-0606
(631) 331-1332
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33D1081165
CLIA
NY
Enumeration date
10/19/2011
Last updated
10/19/2011
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