Healthcare Provider Details

I. General information

NPI: 1790861821
Provider Name (Legal Business Name): NORTHERN ADIRONDACK PLANNED PARENTHOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 BRINKERHOFF ST
PLATTSBURGH NY
12901-2919
US

IV. Provider business mailing address

20 SANBORN AVE
PLATTSBURGH NY
12901-2609
US

V. Phone/Fax

Practice location:
  • Phone: 518-561-0605
  • Fax: 518-561-4522
Mailing address:
  • Phone: 518-561-0605
  • Fax: 518-561-4522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number000281-1
License Number StateNY

VIII. Authorized Official

Name: ROXANNE VASQUEZ
Title or Position: DIRECTOR OF FINANCE, ITS & HR
Credential:
Phone: 518-561-0605