Provider Demographics
NPI:1942285804
Name:CTP NEWTON MEDICAL PC
Entity Type:Organization
Organization Name:CTP NEWTON MEDICAL PC
Other - Org Name:NEWTON MEDICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MANUPELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-869-9692
Mailing Address - Street 1:1770 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4755
Mailing Address - Country:US
Mailing Address - Phone:518-869-9692
Mailing Address - Fax:518-869-7220
Practice Address - Street 1:1770 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4057
Practice Address - Country:US
Practice Address - Phone:518-869-9692
Practice Address - Fax:518-869-7220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care