Provider Demographics
NPI:1811375884
Name:NEWCOURTLAND PRIMARY CARE
Entity Type:Organization
Organization Name:NEWCOURTLAND PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-951-4242
Mailing Address - Street 1:6950 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2120
Mailing Address - Country:US
Mailing Address - Phone:215-951-4304
Mailing Address - Fax:215-951-7723
Practice Address - Street 1:6950 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2120
Practice Address - Country:US
Practice Address - Phone:215-951-4304
Practice Address - Fax:215-951-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care