Provider Demographics
NPI:1568039402
Name:NEWINGTON SPINE AND JOINT, LLC
Entity Type:Organization
Organization Name:NEWINGTON SPINE AND JOINT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SATNARAYAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHALSA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, DC
Authorized Official - Phone:603-781-6613
Mailing Address - Street 1:100 SHATTUCK WAY
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03801-8004
Mailing Address - Country:US
Mailing Address - Phone:603-781-6613
Mailing Address - Fax:
Practice Address - Street 1:100 SHATTUCK WAY
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:NH
Practice Address - Zip Code:03801-8004
Practice Address - Country:US
Practice Address - Phone:603-781-6613
Practice Address - Fax:603-336-3766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy