Provider Demographics
NPI:1881755601
Name:UPPER HUDSON PLANNED PARENTHOOD INC.
Entity type:Organization
Organization Name:UPPER HUDSON PLANNED PARENTHOOD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-434-5678
Mailing Address - Street 1:855 CENTRAL AVE.
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206
Mailing Address - Country:US
Mailing Address - Phone:518-434-5678
Mailing Address - Fax:518-434-8153
Practice Address - Street 1:855 CENTRAL AVE.
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206
Practice Address - Country:US
Practice Address - Phone:518-434-5678
Practice Address - Fax:518-434-8153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0101204R261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00301139Medicaid
NY54268BMedicare PIN