1508839804 NPI number — PLANNED PARENTHOOD OF METROPOLITAN NJ

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508839804 NPI number — PLANNED PARENTHOOD OF METROPOLITAN NJ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF METROPOLITAN NJ
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PPMNJ
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508839804
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
238 MULBERRY STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-622-3900
Provider Business Mailing Address Fax Number:
973-622-1698

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
560 MARTIN LUTHER KING BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
EAST ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-674-4343
Provider Business Practice Location Address Fax Number:
973-674-5581
Provider Enumeration Date:
02/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROGERS-COLLINS
Authorized Official First Name:
ROSLYN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
973-622-3900

Provider Taxonomy Codes

  • Taxonomy code: 261QA0005X , with the licence number:  70793 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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