Provider Demographics
NPI:1003390394
Name:NEW FRONTIERS PSYCHIATRIC SC
Entity Type:Organization
Organization Name:NEW FRONTIERS PSYCHIATRIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HONG
Authorized Official - Middle Name:
Authorized Official - Last Name:YIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-763-6910
Mailing Address - Street 1:2675 N MAYFAIR RD STE 400
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1305
Mailing Address - Country:US
Mailing Address - Phone:414-763-6910
Mailing Address - Fax:414-763-6911
Practice Address - Street 1:2675 N MAYFAIR RD STE 400
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-1305
Practice Address - Country:US
Practice Address - Phone:414-763-6910
Practice Address - Fax:414-763-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty