Provider Demographics
NPI:1467572651
Name:ORANGETOWN PEDIATRIC ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ORANGETOWN PEDIATRIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-359-0010
Mailing Address - Street 1:422 WESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-1311
Mailing Address - Country:US
Mailing Address - Phone:845-359-0010
Mailing Address - Fax:845-359-3414
Practice Address - Street 1:422 WESTERN HWY
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-1311
Practice Address - Country:US
Practice Address - Phone:845-359-0010
Practice Address - Fax:845-359-3414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101931208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00530790Medicaid