Provider Demographics
NPI:1548601537
Name:PLANNED PARENTHOOD SOUTHEASTERN PA
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD SOUTHEASTERN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FOR PATIENT SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:ILENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:215-351-5588
Mailing Address - Street 1:1144 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6734
Mailing Address - Country:US
Mailing Address - Phone:215-351-5588
Mailing Address - Fax:
Practice Address - Street 1:7200 CHESTNUT ST # 102
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-3125
Practice Address - Country:US
Practice Address - Phone:610-626-9482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility