Provider Demographics
NPI:1760455695
Name:PLANNED PARENTHOOD OF METROPOLITAN NJ
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF METROPOLITAN NJ
Other - Org Name:PPMNJ
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS-COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:973-622-3900
Mailing Address - Street 1:238 MULBERRY STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102
Mailing Address - Country:US
Mailing Address - Phone:973-622-3900
Mailing Address - Fax:973-622-1698
Practice Address - Street 1:70 ADAMS STREET
Practice Address - Street 2:SUITE 13
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105
Practice Address - Country:US
Practice Address - Phone:973-465-7707
Practice Address - Fax:973-465-5799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22305261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0007919Medicaid