Healthcare Provider Details
I. General information
NPI: 1508930561
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF NORTHERN, CENTRAL, AND SOUTHERN NEW JERSEY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2006
Last Update Date: 11/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1171 ELIZABETH AVE
ELIZABETH NJ
07201
US
IV. Provider business mailing address
196 SPEEDWELL AVENUE
MORRISTOWN NJ
07960
US
V. Phone/Fax
- Phone: 908-353-0283
- Fax:
- Phone: 973-539-9580
- Fax: 973-539-3828
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0005X |
| Taxonomy | Ambulatory Family Planning Facility |
| License Number | 31D011181 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | D06615808 |
| License Number State | NJ |
VIII. Authorized Official
Name:
SANDY
STILES
Title or Position: SPECIAL PROJECTS LIAISON
Credential:
Phone: 973-539-9580