Provider Demographics
NPI:1578529350
Name:PLANNED PARENTHOOD OF NORTHERN NEW ENGLAND, INC
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF NORTHERN NEW ENGLAND, INC
Other - Org Name:PLANNED PARENTHOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING/LICENSING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RAYCHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-448-9787
Mailing Address - Street 1:784 HERCULES DR STE 110
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-8049
Mailing Address - Country:US
Mailing Address - Phone:802-448-9784
Mailing Address - Fax:802-448-9784
Practice Address - Street 1:784 HERCULES DR STE 110
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-8049
Practice Address - Country:US
Practice Address - Phone:802-448-9784
Practice Address - Fax:802-448-9784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0006041Medicaid
VT0006041Medicaid
VTVT6041Medicare PIN
MEMM5923Medicare PIN