Provider Demographics
NPI:1114336955
Name:PLANNED PARETHOOD OF SOUTHERN NEW ENGLAND
Entity Type:Organization
Organization Name:PLANNED PARETHOOD OF SOUTHERN NEW ENGLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TABAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-752-2816
Mailing Address - Street 1:345 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2348
Mailing Address - Country:US
Mailing Address - Phone:203-752-2856
Mailing Address - Fax:203-852-8785
Practice Address - Street 1:1030 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-2261
Practice Address - Country:US
Practice Address - Phone:860-953-6201
Practice Address - Fax:860-947-2309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005700363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty