Healthcare Provider Details

I. General information

NPI: 1508839804
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF METROPOLITAN NJ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 12/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 MARTIN LUTHER KING BLVD SUITE 100
EAST ORANGE NJ
07017
US

IV. Provider business mailing address

238 MULBERRY STREET
NEWARK NJ
07102
US

V. Phone/Fax

Practice location:
  • Phone: 973-674-4343
  • Fax: 973-674-5581
Mailing address:
  • Phone: 973-622-3900
  • Fax: 973-622-1698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number70793
License Number StateNJ

VIII. Authorized Official

Name: MRS. ROSLYN ROGERS-COLLINS
Title or Position: CEO/PRESIDENT
Credential: MS
Phone: 973-622-3900