1407907215 NPI number — PLANNED PARENTHOOD OF THE NORTH COUNTRY NEW YORK, INC.

Table of content: (NPI 1407907215)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407907215 NPI number — PLANNED PARENTHOOD OF THE NORTH COUNTRY NEW YORK, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF THE NORTH COUNTRY NEW YORK, INC.
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:
PLANNED PARENTHOOD OF NORTHERN NEW YORK, INC.
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:
1407907215
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
160 STONE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WATERTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13601-3250
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-788-8065
Provider Business Mailing Address Fax Number:
315-222-7432

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
160 STONE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATERTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13601-3250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-788-8065
Provider Business Practice Location Address Fax Number:
315-222-7432
Provider Enumeration Date:
01/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
OLECK
Authorized Official First Name:
CHRISTIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
585-546-2771

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  2201201R , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA0005X , with the licence number: 2201201R , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01062844 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00583697 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com