Provider Demographics
NPI:1508930561
Name:PLANNED PARENTHOOD OF NORTHERN, CENTRAL, AND SOUTHERN NEW JERSEY, INC.
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF NORTHERN, CENTRAL, AND SOUTHERN NEW JERSEY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROJECTS LIAISON
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-539-9580
Mailing Address - Street 1:196 SPEEDWELL AVENUE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-539-9580
Mailing Address - Fax:973-539-3828
Practice Address - Street 1:1171 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201
Practice Address - Country:US
Practice Address - Phone:908-353-0283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31D011181261QA0005X
NJD06615808332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0045772Medicaid
NJ0045772Medicaid