Healthcare Provider Details
I. General information
NPI: 1972645042
Provider Name (Legal Business Name): PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
605 CEDAR AVE # 607 PARKVIEW SHOPPING CENTER
YEADON PA
19050-4002
US
IV. Provider business mailing address
1144 LOCUST ST
PHILADELPHIA PA
19107-6734
US
V. Phone/Fax
- Phone: 215-351-5500
- Fax: 215-351-5595
- Phone: 215-351-5500
- Fax: 215-351-5595
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QA0005X |
| Taxonomy | Ambulatory Family Planning Facility |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0002X |
| Taxonomy | Clinic Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VERA
BAILEY
Title or Position: CFO
Credential:
Phone: 215-351-5536