Provider Demographics
NPI:1346213337
Name:PLANNED PARENTHOOD OF METROPOLITAN NEW JERSEY
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF METROPOLITAN NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSLYN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ROGERS COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:973-622-3900
Mailing Address - Street 1:240 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-3528
Mailing Address - Country:US
Mailing Address - Phone:973-622-3900
Mailing Address - Fax:973-622-1698
Practice Address - Street 1:238-240 MULBERRY STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3026
Practice Address - Country:US
Practice Address - Phone:973-622-3900
Practice Address - Fax:973-622-1698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ70791261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0007901Medicaid