NPIMap

Organization Active NPI

Long Island Fertility, PLLC

  • Clinical Medical Laboratory
  • Melville, NY
National Provider Identifier
1275810533
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
33D1081165 Issued in NY
Legal business name
LONG ISLAND FERTILITY, PLLC
Practice address
8 Corporate Center Dr
Suite 101
Melville, NY 11747-3193
Phone
(631) 752-0606
Fax
(631) 331-1332
NPI assigned
Nov 14, 2011
Last updated
Nov 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Diane Ravech, MPA
Title
Vice President, Managed Care
Phone
(860) 678-3428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 33D1081165 NY Primary

Addresses

Primary practice location

8 Corporate Center Dr
Suite 101
Melville, NY 11747-3193

Mailing address

8 Corporate Center Dr
Suite 101
Melville, NY 11747-3193
Phone (631) 752-0606

Other identifiers 1

IdentifierTypeStateIssuer
33D1081165OtherNYCLIA

Other names 1

  • Laboratory at Long Island Fertility, PLLC Other name

National Provider Directory

National Provider Directory
Tax ID family
Laboratory at Long Island Fertility PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1275810533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CORPORATE CENTER DR",
            "address_2": "SUITE 101",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473193",
            "telephone_number": "631-752-0606",
            "fax_number": "631-331-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CORPORATE CENTER DR",
            "address_2": "SUITE 101",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473193",
            "telephone_number": "631-752-0606",
            "fax_number": "631-331-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND FERTILITY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "RAVECH",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "VICE PRESIDENT, MANAGED CARE",
        "authorized_official_telephone_number": "860-678-3428",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "33D1081165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "33D1081165",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratory at Long Island Fertility, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.