Organization
ESSE INTEGRATED REPRODUCTIVE SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON PROVOST (COO)
(832) 515-6129
Entity
Organization
Contact information
Practice address
535 5TH AVE, NEW YORK, NY 10017-3620
(646) 844-9602
Mailing address
204 CORLIES AVE, PELHAM, NY 10803-1904
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
06/06/2025
Last updated
06/06/2025
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