Provider Demographics
NPI:1013035112
Name:PLANNED PARENTHOOD OF THE MID-HUDSON VALLEY INC
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF THE MID-HUDSON VALLEY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:DOROTHY
Authorized Official - Last Name:RADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:845-471-1530
Mailing Address - Street 1:178 CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-471-1530
Mailing Address - Fax:845-471-1519
Practice Address - Street 1:136 LAKE ST
Practice Address - Street 2:SUITE 11
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5245
Practice Address - Country:US
Practice Address - Phone:845-471-1530
Practice Address - Fax:845-471-1519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1302207R261QA0005X, 261QF0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00245258Medicaid