Provider Demographics
NPI:1619193489
Name:NEWTON HEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:NEWTON HEALTH & WELLNESS LLC
Other - Org Name:NEWTON FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-300-1850
Mailing Address - Street 1:94 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-1721
Mailing Address - Country:US
Mailing Address - Phone:973-300-1850
Mailing Address - Fax:973-300-1840
Practice Address - Street 1:94 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-1721
Practice Address - Country:US
Practice Address - Phone:973-300-1850
Practice Address - Fax:973-300-1840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJX007966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ023501Medicare ID - Type Unspecified