Provider Demographics
NPI:1730308537
Name:PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:TABAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-752-2816
Mailing Address - Street 1:345 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511
Mailing Address - Country:US
Mailing Address - Phone:203-752-2856
Mailing Address - Fax:203-752-8785
Practice Address - Street 1:111 POINT ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02940
Practice Address - Country:US
Practice Address - Phone:401-421-7820
Practice Address - Fax:401-421-9668
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-24
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI01002261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIPP00116Medicaid
RIPP00116Medicaid