Healthcare Provider Details

I. General information

NPI: 1184679722
Provider Name (Legal Business Name): PLANNED PARENTHOOD LEAGUE OF MA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KAREN LOEB LIFFORD MD 631 LINCOLN ST
WORCESTER MA
01605
US

IV. Provider business mailing address

1055 COMMONWEALTH AVE
BOSTON MA
02215-1001
US

V. Phone/Fax

Practice location:
  • Phone: 508-854-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number4174
License Number StateMA

VIII. Authorized Official

Name: MEAGON GALLAGHER
Title or Position: VP COO
Credential:
Phone: 617-616-1660