Provider Demographics
NPI:1043423148
Name:NEW BEGINNINGS DERMA SPA
Entity Type:Organization
Organization Name:NEW BEGINNINGS DERMA SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ATHINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-226-1622
Mailing Address - Street 1:43630 HAYES RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-3545
Mailing Address - Country:US
Mailing Address - Phone:586-226-1622
Mailing Address - Fax:586-226-1610
Practice Address - Street 1:43630 HAYES RD
Practice Address - Street 2:SUITE 240
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-3545
Practice Address - Country:US
Practice Address - Phone:586-226-1622
Practice Address - Fax:586-226-1610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty