Provider Demographics
NPI:1851335277
Name:NEW CASTLE CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:NEW CASTLE CHIROPRACTIC, PA
Other - Org Name:DBA MAIN STREET FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-737-8667
Mailing Address - Street 1:280 E MAIN ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-7333
Mailing Address - Country:US
Mailing Address - Phone:302-737-8667
Mailing Address - Fax:
Practice Address - Street 1:280 E MAIN ST
Practice Address - Street 2:SUITE 111
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7333
Practice Address - Country:US
Practice Address - Phone:302-737-8667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW CASTLE CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-15
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE50938Medicare UPIN
DE143867Medicare ID - Type Unspecified