Provider Demographics
NPI:1417945692
Name:NORTHERN ADIRONDACK PLANNED PARENTHOOD INC
Entity type:Organization
Organization Name:NORTHERN ADIRONDACK PLANNED PARENTHOOD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WUNDERLICH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:518-561-0605
Mailing Address - Street 1:66 BRINKERHOFF ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2919
Mailing Address - Country:US
Mailing Address - Phone:518-561-4430
Mailing Address - Fax:518-561-4522
Practice Address - Street 1:66 BRINKERHOFF ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2919
Practice Address - Country:US
Practice Address - Phone:518-561-4430
Practice Address - Fax:518-561-4522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0901201R261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00583748Medicaid