Provider Demographics
NPI:1326367665
Name:NEW BEGINNINGS PEDIATRICS, PLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS PEDIATRICS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRITIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:GISELA
Authorized Official - Last Name:VILLANUEVA SCHWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-594-7337
Mailing Address - Street 1:18699 N 67TH AVE
Mailing Address - Street 2:240
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7140
Mailing Address - Country:US
Mailing Address - Phone:623-594-7337
Mailing Address - Fax:623-594-7340
Practice Address - Street 1:18699 N 67TH AVE
Practice Address - Street 2:240
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7140
Practice Address - Country:US
Practice Address - Phone:623-594-7337
Practice Address - Fax:623-594-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34314208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ964438Medicaid
1255446738OtherNPPES - INDVIDUAL NPI