Healthcare Provider Details

I. General information

NPI: 1376618843
Provider Name (Legal Business Name): PLANNED PARENTHOOD MOHAWK HUDSON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 03/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 STATE STREET
SCHENECTADY NY
12307-1508
US

IV. Provider business mailing address

1040 STATE STREET
SCHENECTADY NY
12307-1508
US

V. Phone/Fax

Practice location:
  • Phone: 518-374-5353
  • Fax: 518-347-1413
Mailing address:
  • Phone: 518-374-5353
  • Fax: 518-347-1413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number4601211R
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberBC4135580
License Number StateNY

VIII. Authorized Official

Name: PATRICE R MCFADDEN
Title or Position: INSURANCE COORDINATOR
Credential:
Phone: 518-374-5353