| Organization Name: | FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER, LLC |
| NPI Number: | 1497117113 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARC PORTMANN (ADMINISTRATOR) |
| Mailing Address: | 945 Chesterbrook Blvd Chesterbrook |
| State: | PA US |
| Postal Code: | 190875614 |
| Phone Number: | 6109816000 |
| Fax Number: | 6109640536 |
| NPI Enumeration Date: | 03/22/2016 |
| NPI Last Update Date: | 03/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |