Healthcare Provider Details

I. General information

NPI: 1578693636
Provider Name (Legal Business Name): PLANNED PARENTHOOD LEAGUE OF MASSACHUSETTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 10/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SAINT PAUL DR
WORCESTER MA
01602-1519
US

IV. Provider business mailing address

3 SAINT PAUL DR
WORCESTER MA
01602-1519
US

V. Phone/Fax

Practice location:
  • Phone: 508-756-6078
  • Fax:
Mailing address:
  • Phone: 508-756-6078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number1247
License Number StateMA

VIII. Authorized Official

Name: KAREN CAPONI
Title or Position: HEALTH SERVICES DIRECTOR
Credential:
Phone: 508-854-3300