1023136157 NPI number — PLANNED PARENTHOOD OF THE MID-HUDSON VALLEY

Table of content: (NPI 1023136157)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023136157 NPI number — PLANNED PARENTHOOD OF THE MID-HUDSON VALLEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF THE MID-HUDSON VALLEY
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:
Provider Other Organization Name Type Code:
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:
1023136157
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
178 CHURCH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POUGHKEEPSIE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12601-4165
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-471-1530
Provider Business Mailing Address Fax Number:
845-471-1644

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3312 ROUTE 343
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMENIA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-373-9933
Provider Business Practice Location Address Fax Number:
845-373-9935
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CARR
Authorized Official First Name:
KYRA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
VP OF PATIENT SERVICES
Authorized Official Telephone Number:
845-562-5748

Provider Taxonomy Codes

  • Taxonomy code: 261QA0005X , with the licence number:  1302207R , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QF0050X , with the licence number: 1302207R , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 00245258 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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