Healthcare Provider Details

I. General information

NPI: 1881780948
Provider Name (Legal Business Name): PLANNED PARENTHOOD ASSOC. OF THE MERCER AREA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 E STATE ST
TRENTON NJ
08608-1501
US

IV. Provider business mailing address

437 E STATE ST
TRENTON NJ
08608-1501
US

V. Phone/Fax

Practice location:
  • Phone: 609-599-4881
  • Fax: 609-989-4846
Mailing address:
  • Phone: 609-599-4881
  • Fax: 609-989-4846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberMA51433
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License NumberMA51433
License Number StateNJ

VIII. Authorized Official

Name: CAROLYN LALLY
Title or Position: DIRECTOR OF BILLING AND REVENUE C
Credential:
Phone: 973-539-9580