| Organization Name: | SHADY GROVE FERTILITY CENTER OF PENNSYLVANIA PLC |
| NPI Number: | 1922353366 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK SEGAL (CEO) |
| Mailing Address: | 945 Chesterbrook Blvd Chesterbrook |
| State: | PA US |
| Postal Code: | 190875614 |
| Phone Number: | 6109816000 |
| Fax Number: | |
| NPI Enumeration Date: | 07/23/2012 |
| NPI Last Update Date: | 07/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VE0102X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Reproductive Endocrinology |
| Taxonomy Definition: | An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |