Provider Demographics
NPI:1003940974
Name:VILLAGE AT NEWTOWN MEDICAL CENTER, P.C.
Entity Type:Organization
Organization Name:VILLAGE AT NEWTOWN MEDICAL CENTER, P.C.
Other - Org Name:VILLAGE AT NEWTOWN CHIRO
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTIC MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-579-1300
Mailing Address - Street 1:11 FRIENDS LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1803
Mailing Address - Country:US
Mailing Address - Phone:215-579-1300
Mailing Address - Fax:215-579-9039
Practice Address - Street 1:11 FRIENDS LN
Practice Address - Street 2:SUITE 110
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1803
Practice Address - Country:US
Practice Address - Phone:215-579-1300
Practice Address - Fax:215-579-9039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA608662Medicare ID - Type Unspecified
PA675052Medicare ID - Type Unspecified