Provider Demographics
NPI:1629529086
Name:NEW VITAE INC
Entity Type:Organization
Organization Name:NEW VITAE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, PROJECT MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-965-9021
Mailing Address - Street 1:16 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1118
Mailing Address - Country:US
Mailing Address - Phone:215-538-3403
Mailing Address - Fax:215-538-3402
Practice Address - Street 1:5646 WALNUT STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-3920
Practice Address - Country:US
Practice Address - Phone:610-965-9021
Practice Address - Fax:215-472-6580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007458450Medicaid
PA020644Medicare PIN