Provider Demographics
NPI:1033525274
Name:NEW STANTON PRIMARY CARE
Entity Type:Organization
Organization Name:NEW STANTON PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JABBOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-925-1199
Mailing Address - Street 1:512 S CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW STANTON
Mailing Address - State:PA
Mailing Address - Zip Code:15672-9714
Mailing Address - Country:US
Mailing Address - Phone:724-925-1199
Mailing Address - Fax:
Practice Address - Street 1:512 S CENTER AVE
Practice Address - Street 2:
Practice Address - City:NEW STANTON
Practice Address - State:PA
Practice Address - Zip Code:15672-9714
Practice Address - Country:US
Practice Address - Phone:724-925-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD063210-L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care