Provider Demographics
NPI:1164592168
Name:THE FAMILY PRACTICE CENTER OF NEW CASTLE, PA
Entity Type:Organization
Organization Name:THE FAMILY PRACTICE CENTER OF NEW CASTLE, PA
Other - Org Name:ABBY FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLEN
Authorized Official - Middle Name:DREW
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-999-0933
Mailing Address - Street 1:1 CENTURIAN DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2137
Mailing Address - Country:US
Mailing Address - Phone:302-999-0933
Mailing Address - Fax:302-999-8633
Practice Address - Street 1:1 CENTURIAN DR
Practice Address - Street 2:SUITE 105
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2137
Practice Address - Country:US
Practice Address - Phone:302-999-0933
Practice Address - Fax:302-999-8633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1999208770111N00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000740771OtherHIGHMARK BS
0531163000OtherAMERIHEALTH
MD771103400Medicaid
DE0001043202Medicaid
DE27643OtherCOVENTRY
343RFAOtherCAREFIRST BS
DE27643OtherCOVENTRY
MD771103400Medicaid
MD771103400Medicaid
DE0001043202Medicaid
DEG00312Medicare ID - Type Unspecified