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ILLUME FERTILITY PLLC NPI 1013179902


NPI Information

NPI: 1013179902
Provider Name: ILLUME FERTILITY, PLLC

Other Name: AMBULATORY SURGICAL CENTER AT REPRODUCTIVE MEDICINE

Classification: Clinic/Center - 261QA0006X
Entity Type: Organization

Specialization: Ambulatory Fertility Facility

Address:
761 MAIN AVE
SUITE 200
NORWALK, CT
ZIP 06851
Phone: (203) 750-7400
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ILLUME FERTILITY, PLLC is an ambulatory fertility facility clinic center in Norwalk, CT. The provider is a fertility facility, which may be licensed, registered, or certified in some states, that is not hospital-based, where services are provided at a fixed specific location. An Ambulatory Fertility Facility does not provide overnight accommodations. The following fertility procedures may be performed at an Ambulatory Fertility Facility: In Vitro Fertilization (IVF), Gamete Intrafallopian Transfer (GIFT), Embryo Transfer-Thaw (ET-T), Zygote Intrafallopian Transfer (ZIFT), Donor OOCYTE (DO) ILLUME FERTILITY, PLLC NPI is 1013179902. The provider is registered as an organization entity type.
The provider Other Name Is Ambulatory Surgical Center At Reproductive Medicine.

The provider's business location address is:

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

The provider's authorized official is Robin Mangieri .
The authorized official title is Ceo and has the following contact phone number (203) 750-7400.

The enumeration date for this NPI number is 7/1/2008 and was last updated on 4/4/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA1903XClinic/CenterAmbulatory Surgical0320CONNECTICUTNo
2261QA0006XClinic/CenterAmbulatory Fertility FacilityYes

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

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