Provider Demographics
NPI:1265599344
Name:GYNECOLOGIC & REPRODUCTIVE SERVICES PC
Entity type:Organization
Organization Name:GYNECOLOGIC & REPRODUCTIVE SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HENNING
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:315-598-7057
Mailing Address - Street 1:1650 STATE ROUTE 48
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-4107
Mailing Address - Country:US
Mailing Address - Phone:315-598-7057
Mailing Address - Fax:315-593-3708
Practice Address - Street 1:1650 STATE ROUTE 48
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-4107
Practice Address - Country:US
Practice Address - Phone:315-598-7057
Practice Address - Fax:315-593-3708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB69246Medicare UPIN
NYDD6261Medicare PIN