Healthcare Provider Details

I. General information

NPI: 1770657736
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

46 N VAN BRUNT ST
ENGLEWOOD NJ
07631-2707
US

IV. Provider business mailing address

196 SPEEDWELL AVENUE
MORRISTOWN NJ
07960
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-0966
  • Fax: 201-568-4986
Mailing address:
  • Phone: 973-539-9580
  • Fax: 973-539-3828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberDO6615805
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number31D0111811
License Number StateNJ

VIII. Authorized Official

Name: SANDY STILES
Title or Position: SPECIAL PROJECTS LIAISON
Credential:
Phone: 973-539-9580