Organization
MAIN LINE FERTILITY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANNE DEBENEDICTIS (VICE PRESIDENT, PAYOR RELATIONS)
(713) 254-3601
Entity
Organization
Contact information
Practice address
825 OLD LANCASTER RD STE 170, BRYN MAWR, PA 19010-3234
(610) 527-0800
Mailing address
4828 LOOP CENTRAL DR STE 900, HOUSTON, TX 77081-2220
(610) 527-0800
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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