Provider Demographics
NPI:1497081194
Name:PLANNED PARENTHOOD OF NORTHERN NEW ENGLAND
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF NORTHERN NEW ENGLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:JB
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-448-9719
Mailing Address - Street 1:128 LAKESIDE AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4939
Mailing Address - Country:US
Mailing Address - Phone:802-448-9719
Mailing Address - Fax:802-660-9438
Practice Address - Street 1:108 HIGH ST
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2939
Practice Address - Country:US
Practice Address - Phone:603-772-9315
Practice Address - Fax:603-772-8091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RE5243Medicare PIN