1013035112 NPI number — PLANNED PARENTHOOD OF THE MID-HUDSON VALLEY INC

Table of content: (NPI 1013035112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013035112 NPI number — PLANNED PARENTHOOD OF THE MID-HUDSON VALLEY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF THE MID-HUDSON VALLEY 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:
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:
1013035112
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
178 CHURCH STREET
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
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-471-1530
Provider Business Mailing Address Fax Number:
845-471-1519

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
136 LAKE ST
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
NEWBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12550-5245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-471-1530
Provider Business Practice Location Address Fax Number:
845-471-1519
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RADFORD
Authorized Official First Name:
MARY
Authorized Official Middle Name:
DOROTHY
Authorized Official Title or Position:
VP OF FINANCE
Authorized Official Telephone Number:
845-471-1530

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: "Y" .
  • 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: "N" .

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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