Provider Demographics
NPI:1154791333
Name:PLANNED PARENTHOOD OF HUDSON PECONIC
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF HUDSON PECONIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES GENERALIST
Authorized Official - Prefix:
Authorized Official - First Name:TAWANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-467-7341
Mailing Address - Street 1:4421 BAYOU RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-8649
Mailing Address - Country:US
Mailing Address - Phone:850-776-4658
Mailing Address - Fax:
Practice Address - Street 1:4421 BAYOU RIDGE DR
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-8649
Practice Address - Country:US
Practice Address - Phone:850-776-4658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9280320261QA0005X, 261QC1500X, 261QF0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical