Provider Demographics
NPI:1144200015
Name:REPRODUCTIVE MEDICINE ASSOCIATES OF PHILADELPHIA
Entity type:Organization
Organization Name:REPRODUCTIVE MEDICINE ASSOCIATES OF PHILADELPHIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-656-2840
Mailing Address - Street 1:140 ALLEN ROAD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920
Mailing Address - Country:US
Mailing Address - Phone:866-762-3140
Mailing Address - Fax:937-290-8370
Practice Address - Street 1:880 E. SWEDESFORD RD.
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087
Practice Address - Country:US
Practice Address - Phone:215-654-1544
Practice Address - Fax:215-654-1543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC32966Medicare UPIN