Provider Demographics
NPI:1659457836
Name:TPB MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:TPB MEDICAL SERVICES PC
Other - Org Name:NEWTON MEDICAL III
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOBHARANI
Authorized Official - Middle Name:
Authorized Official - Last Name:POTLURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-356-7818
Mailing Address - Street 1:2727 HAMBURG ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303
Mailing Address - Country:US
Mailing Address - Phone:518-356-7818
Mailing Address - Fax:518-356-8199
Practice Address - Street 1:2727 HAMBURG ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303
Practice Address - Country:US
Practice Address - Phone:518-356-7818
Practice Address - Fax:518-356-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care