ILLUME FERTILITY PLLC NPI 1013086727

NPI Information

NPI: 1013086727
Provider Name: ILLUME FERTILITY, PLLC

Former Legal Business Name: REPRODUCTIVE MEDICINE ASSOCIATES OF CONNECTICUT, PC

Classification: Obstetrics & Gynecology - 207VE0102X
Entity Type: Organization

Specialization: Reproductive Endocrinology

Address:
761 MAIN AVE
SUITE 200
NORWALK, CT
ZIP 06851
Phone: (203) 750-7400
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ILLUME FERTILITY, PLLC is a reproductive endocrinology obstetrics gynecology in Norwalk, CT. The provider is an obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. ILLUME FERTILITY, PLLC NPI is 1013086727. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Reproductive Medicine Associates Of Connecticut, Pc.

The provider's business location address is:

761 MAIN AVE
SUITE 200
NORWALK, CT
ZIP 06851-080
Phone: (203) 750-7400
Fax: (203) 846-9579

The provider's authorized official is Robin Mangieri .
The authorized official title is Ceo and has the following contact phone number (203) 912-3137.

The CLIA number assigned to this NPI record is 07D0973463 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 11/7/2006 and was last updated on 3/1/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VE0102X	Obstetrics & Gynecology	Reproductive Endocrinology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	753059794	OTHER	CONNECTICUT	TAX IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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