Main Line Fertility Clinic PC

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

Legal business name

MAIN LINE FERTILITY CLINIC PC

Practice address

825 Old Lancaster Rd Ste 170
Bryn Mawr, PA 19010-3234

Phone

(610) 527-0800

NPI assigned

Jun 23, 2023

Last updated

Jun 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marianne Debenedictis

Title

Vice President, Payor Relations

Phone

(713) 254-3601

Specialties & licenses 1

Addresses

Tax ID family

Main Line Fertility Clinic2 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.

• Main Line Fertility Clinic PC

  • Reproductive Endocrinology Physician
  • Bryn Mawr, PA
  • NPI 1932834082
  NPD tax ID

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1427734599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4828 LOOP CENTRAL DR STE 900",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770812220",
            "telephone_number": "610-527-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 OLD LANCASTER RD STE 170",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103234",
            "telephone_number": "610-527-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE FERTILITY CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "DEBENEDICTIS",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_title_or_position": "VICE PRESIDENT, PAYOR RELATIONS",
        "authorized_official_telephone_number": "713-254-3601"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Main Line Counseling Partners
• Main Line Family Dentistry
• Main Line Family Practice
• Main Line Fertility & Reproductive Med LTD
• Main Line Fertility Center
• Main Line Fertility Clinic PC
• Main Line Hospitals, Inc.
• Main Line Hospitals, Inc. (Bryn Mawr Hospital)
• Main Line Hospitals, Inc. (Bryn Mawr Hospital)
• Main Line Medical Exercise, Inc.

• Reproductive Endocrinology Physician in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Reproductive Endocrinology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.