Provider Demographics
NPI:1245759232
Name:NEWLANDS HEALTH
Entity Type:Organization
Organization Name:NEWLANDS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KWAKWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-941-1515
Mailing Address - Street 1:9625 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2846
Mailing Address - Country:US
Mailing Address - Phone:215-941-1515
Mailing Address - Fax:215-941-1356
Practice Address - Street 1:9625 FRANKFORD AVE.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114
Practice Address - Country:US
Practice Address - Phone:215-941-1515
Practice Address - Fax:215-941-1356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058142L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001564180Medicaid