Provider Demographics
NPI:1609942341
Name:PLANNED PARENTHOOD OF CENTRAL AND GREATER NORTHERN NJ
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF CENTRAL AND GREATER NORTHERN NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMAN
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 1:203 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:MANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08835
Practice Address - Country:US
Practice Address - Phone:908-231-9230
Practice Address - Fax:908-231-1565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31D0111811261QA0005X
NJD06615804332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0045756Medicaid
NJ0045756Medicaid