Provider Demographics
NPI:1881780948
Name:PLANNED PARENTHOOD ASSOC. OF THE MERCER AREA, INC.
Entity type:Organization
Organization Name:PLANNED PARENTHOOD ASSOC. OF THE MERCER AREA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING AND REVENUE C
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LALLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-539-9580
Mailing Address - Street 1:437 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08608-1501
Mailing Address - Country:US
Mailing Address - Phone:609-599-4881
Mailing Address - Fax:609-989-4846
Practice Address - Street 1:437 E STATE ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08608-1501
Practice Address - Country:US
Practice Address - Phone:609-599-4881
Practice Address - Fax:609-989-4846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA51433332900000X, 261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0011509Medicaid
NJX93077Medicare UPIN
NJ071145Medicare ID - Type Unspecified