Provider Demographics
NPI:1427090190
Name:PLANNED PARENTHOOD OF GREATER NEW YORK
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF GREATER NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:NORDENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-274-7226
Mailing Address - Street 1:540 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4364
Mailing Address - Country:US
Mailing Address - Phone:516-750-2613
Mailing Address - Fax:516-483-3592
Practice Address - Street 1:540 FULTON AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4364
Practice Address - Country:US
Practice Address - Phone:516-750-2614
Practice Address - Fax:516-483-3592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00385135Medicaid
NY00385135Medicaid