Healthcare Provider Details

I. General information

NPI: 1730308537
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 10/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 POINT ST
PROVIDENCE RI
02940
US

IV. Provider business mailing address

345 WHITNEY AVE
NEW HAVEN CT
06511
US

V. Phone/Fax

Practice location:
  • Phone: 401-421-7820
  • Fax: 401-421-9668
Mailing address:
  • Phone: 203-752-2856
  • Fax: 203-752-8785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number01002
License Number StateRI

VIII. Authorized Official

Name: JUDITH TABAR
Title or Position: PRESIDENT & CEO
Credential:
Phone: 203-752-2816